Provider Demographics
NPI:1780791053
Name:SPEICHER, GREG ALLEN (PHARMD, CDE)
Entity type:Individual
Prefix:DR
First Name:GREG
Middle Name:ALLEN
Last Name:SPEICHER
Suffix:
Gender:M
Credentials:PHARMD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7631 SOUTHCLIFF DRIVE
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-7327
Mailing Address - Country:US
Mailing Address - Phone:916-203-3235
Mailing Address - Fax:
Practice Address - Street 1:7631 SOUTHCLIFF DR
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-7327
Practice Address - Country:US
Practice Address - Phone:916-961-0243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA523091835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy