Provider Demographics
NPI:1033685276
Name:GELLAD, MICHEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHEL
Middle Name:
Last Name:GELLAD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 HAMILTON CT
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-6474
Mailing Address - Country:US
Mailing Address - Phone:916-396-3740
Mailing Address - Fax:
Practice Address - Street 1:3020 GREEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-7658
Practice Address - Country:US
Practice Address - Phone:530-676-6352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-15
Last Update Date:2023-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79667183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist