Provider Demographics
NPI:1790122117
Name:SPELBRING, GARALD VINCENT (RPH)
Entity Type:Individual
Prefix:MR
First Name:GARALD
Middle Name:VINCENT
Last Name:SPELBRING
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2355 CLARKIE WAY
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-5301
Mailing Address - Country:US
Mailing Address - Phone:805-473-8785
Mailing Address - Fax:
Practice Address - Street 1:2355 CLARKIE WAY
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-5301
Practice Address - Country:US
Practice Address - Phone:805-473-8785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist