Michael James Gorence, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

60684 Issued in CA

Practice address

9728 Winter Gardens Blvd
Lakeside, CA 92040-3809

Phone

(619) 938-0069

Fax

(619) 938-9565

NPI assigned

Nov 14, 2011

Sex

Male

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co.

  • Pharmacy
  • Lakeside, CA
  • NPI 1306075890
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 14, 2011.

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1003193368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9728 WINTER GARDENS BLVD",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920403809",
            "telephone_number": "619-938-0069",
            "fax_number": "619-938-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9728 WINTER GARDENS BLVD",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920403809",
            "telephone_number": "619-938-0069",
            "fax_number": "619-938-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORENCE",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-14",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "60684",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00065853",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• GHC of Lakeside, LLC
• Zach Glascox
• Janice Torres Gonzalez
• Good Care Transportation, LLC
• Shawn Goodwin
• Don Richard Graham, D.D.S.
• Grant and Pham Dental Corporation
• Ray Gros
• Raewyn Guerrero
• John-Paul M Guillot, DPM

• All providers in Lakeside, CA
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.