Provider Demographics
NPI:1629487822
Name:GERARD, HOLLY (PHARMD)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:GERARD
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 1:7860 WESTSIDE DR
Mailing Address - Street 2:212
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1213
Mailing Address - Country:US
Mailing Address - Phone:407-756-0961
Mailing Address - Fax:
Practice Address - Street 1:7860 WESTSIDE DR
Practice Address - Street 2:212
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1213
Practice Address - Country:US
Practice Address - Phone:407-756-0961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69909183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist