Provider Demographics
NPI:1578177374
Name:GALLAGHER, MEGAN ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANN
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ANN
Other - Last Name:MCARDLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2321 SAN JOAQUIN PLZ
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5968
Mailing Address - Country:US
Mailing Address - Phone:631-404-6242
Mailing Address - Fax:
Practice Address - Street 1:4255 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-8650
Practice Address - Country:US
Practice Address - Phone:949-509-9840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064728183500000X
CA82138183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist