Provider Demographics
NPI:1184384919
Name:SOARES, GARRET FRANK (PHARMD)
Entity type:Individual
Prefix:
First Name:GARRET
Middle Name:FRANK
Last Name:SOARES
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 1:1017 ELLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-2621
Mailing Address - Country:US
Mailing Address - Phone:661-725-9489
Mailing Address - Fax:
Practice Address - Street 1:1017 ELLINGTON ST
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-2621
Practice Address - Country:US
Practice Address - Phone:661-725-9489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH84583183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist