Provider Demographics
NPI:1568751337
Name:FOSTER, DOUGLAS RICHARD (PHARMD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:RICHARD
Last Name:FOSTER
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 1:2593 SAN GABRIEL AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-8903
Mailing Address - Country:US
Mailing Address - Phone:559-970-5647
Mailing Address - Fax:
Practice Address - Street 1:2593 SAN GABRIEL AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-8903
Practice Address - Country:US
Practice Address - Phone:559-970-5647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27165183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist