Provider Demographics
NPI:1689918633
Name:GITIHA, JEREMIAH (PHARMD)
Entity Type:Individual
Prefix:
First Name:JEREMIAH
Middle Name:
Last Name:GITIHA
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 1:285 LONDON ST
Mailing Address - Street 2:APT 2
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-2028
Mailing Address - Country:US
Mailing Address - Phone:415-609-6858
Mailing Address - Fax:
Practice Address - Street 1:2540 EAST ST
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1906
Practice Address - Country:US
Practice Address - Phone:925-674-2130
Practice Address - Fax:925-674-2570
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65595183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist