Provider Demographics
NPI:1629774914
Name:GARRETT, JOHN CRAIG (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CRAIG
Last Name:GARRETT
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 1:4533 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-1131
Mailing Address - Country:US
Mailing Address - Phone:925-451-0865
Mailing Address - Fax:619-686-3794
Practice Address - Street 1:4044 FIFTH AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2106
Practice Address - Country:US
Practice Address - Phone:925-451-0865
Practice Address - Fax:619-686-3794
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA728741835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology