Provider Demographics
NPI:1104887637
Name:GNESA, HENRY (PHARM D)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:
Last Name:GNESA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 SPERRY AVE
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:CA
Mailing Address - Zip Code:95363-9266
Mailing Address - Country:US
Mailing Address - Phone:209-892-4545
Mailing Address - Fax:
Practice Address - Street 1:1035 SPERRY AVE
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:CA
Practice Address - Zip Code:95363-9266
Practice Address - Country:US
Practice Address - Phone:209-892-4545
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist