Provider Demographics
NPI:1669474680
Name:GATES, RYAN JAMES (PHARM D)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:JAMES
Last Name:GATES
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W MINERAL KING AVE
Mailing Address - Street 2:INPATIENT PHARMACY
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-6237
Mailing Address - Country:US
Mailing Address - Phone:559-624-5647
Mailing Address - Fax:559-713-2442
Practice Address - Street 1:400 W MINERAL KING AVE
Practice Address - Street 2:INPATIENT PHARMACY
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-6237
Practice Address - Country:US
Practice Address - Phone:559-624-5647
Practice Address - Fax:559-713-2442
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56260183500000X, 1835P1200X
CARPH 562601835G0303X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric