Individual provider · Type 1 NPI

Michelle Gandawidjaja

Pharmacist · Newport Beach, CA

NPI number 1871448795 Active

Practice location

1 Hoag Dr
Newport Beach, CA 92663-4162

Call (949) 764-4624 Map

Mailing address

272 Novel
Irvine, CA 92618-1792

Specialties and licenses

TaxonomyCodeLicense
Pharmacist Primary 183500000X82814 (CA)

Pharmacist: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage…

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About NPI 1871448795

Michelle Gandawidjaja's National Provider Identifier is 1871448795, issued on Mar 4, 2026. The primary taxonomy on file is Pharmacist (183500000X), and the practice location is in Newport Beach, CA. The record was last updated on Mar 4, 2026.