Provider Demographics
NPI:1912538372
Name:ADAMS, MICHAEL DON (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DON
Last Name:ADAMS
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:FAIRCHILD MEDICAL CLINIC
Mailing Address - Street 2:475 BRUCE STREET
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097-9530
Mailing Address - Country:US
Mailing Address - Phone:530-842-3507
Mailing Address - Fax:
Practice Address - Street 1:475 BRUCE ST
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097-3474
Practice Address - Country:US
Practice Address - Phone:530-842-3507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81804183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist