Provider Demographics
NPI:1083655146
Name:HUTCHISON, MICHAEL D (PHARMD,CDM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:HUTCHISON
Suffix:
Gender:M
Credentials:PHARMD,CDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2075 BURU PL
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-7318
Mailing Address - Country:US
Mailing Address - Phone:707-268-2447
Mailing Address - Fax:707-442-4023
Practice Address - Street 1:714 F ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-1036
Practice Address - Country:US
Practice Address - Phone:707-268-2448
Practice Address - Fax:707-442-4023
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39884183500000X
OR9087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist