Provider Demographics
NPI:1083914139
Name:TOGONON, MICHELLE GALLER (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:GALLER
Last Name:TOGONON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 HARBISON DR
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-3902
Mailing Address - Country:US
Mailing Address - Phone:707-452-7279
Mailing Address - Fax:707-452-7282
Practice Address - Street 1:2090 HARBISON DR
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-3902
Practice Address - Country:US
Practice Address - Phone:707-452-7279
Practice Address - Fax:707-452-7282
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH60059183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist