Eric Eivind Gjerdrum, PHARMD

Primary specialty

Pharmacotherapy PharmacistTaxonomy code 1835P1200X

License

0051070 Issued in CA

Practice address

1540 Froom Ranch Way
San Luis Obispo, CA 93405-7211

Phone

(805) 541-7028

Fax

(805) 541-7025

NPI assigned

Oct 12, 2009

Last updated

Oct 12, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255305600000",
    "number": "1831424647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 IDYLLWILD PL",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934209632",
            "telephone_number": "805-343-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 FROOM RANCH WAY",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934057211",
            "telephone_number": "805-541-7028",
            "fax_number": "805-541-7025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GJERDRUM",
        "first_name": "ERIC",
        "middle_name": "EIVIND",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-12",
        "last_updated": "2009-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "CA",
            "license": "0051070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacotherapy Pharmacist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Pharmacotherapy Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2009; 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.