DR. Gajan Tristan Mathivanan, PHARM.D

NPI #1609485044 in Angels Camp, California

Provider Information

NPI Number: 1609485044
Entity Type: Individual
Name: DR. Gajan Tristan Mathivanan, PHARM.D
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: PHARM.D
Enumeration Date: Jul 30, 2020
Last Updated: Jul 30, 2020

Practice Location

Address: 230 S MAIN ST
City: Angels Camp
State: California
ZIP Code: 95222-9359
Phone: (209) 736-4623

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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