Provider Demographics
NPI:1124009246
Name:GRAMLICH, BERNARD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:
Last Name:GRAMLICH
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:PO BOX 9227
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-4227
Mailing Address - Country:US
Mailing Address - Phone:858-759-6625
Mailing Address - Fax:858-759-6729
Practice Address - Street 1:16089 SAN DIEGUITO ROAD H 102/9227
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA FE
Practice Address - State:CA
Practice Address - Zip Code:92067-9206
Practice Address - Country:US
Practice Address - Phone:858-759-6625
Practice Address - Fax:858-759-6927
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53112183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY55594OtherPHARMACY LICENSE