Provider Demographics
NPI:1730628462
Name:CHANJAMSRI, GARN (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:GARN
Middle Name:
Last Name:CHANJAMSRI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 E LAMBERT RD
Mailing Address - Street 2:OUTPATIENT PHARMACY
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-4371
Mailing Address - Country:US
Mailing Address - Phone:714-672-5230
Mailing Address - Fax:
Practice Address - Street 1:1900 E LAMBERT RD
Practice Address - Street 2:OUTPATIENT PHARMACY
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-4371
Practice Address - Country:US
Practice Address - Phone:714-672-5230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist