Provider Demographics
NPI:1336687227
Name:KAWASHIMA, GARY DEAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:DEAN
Last Name:KAWASHIMA
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 1:4175 E LA PALMA AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-1842
Mailing Address - Country:US
Mailing Address - Phone:714-279-5060
Mailing Address - Fax:714-279-4689
Practice Address - Street 1:4175 E LA PALMA AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-1842
Practice Address - Country:US
Practice Address - Phone:714-279-5060
Practice Address - Fax:714-279-4689
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43758183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist