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NPI Code Detail

MEDICARE: NIKITA MAINALY PHARMD

MEDICARE: NIKITA MAINALY PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist87182CA

General Provider Information

NPI Number : 1033828413
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIKITA MAINALY PHARMD
Provider Business Mailing Address
First Line : 6200 SAN RAMON WAY
Second Line :
City : BUENA PARK
State : CA
Zip : 90620-2840
Country : US
Telephone Number : 714-594-8845
Fax Number :
Provider Business Practice Location Address
First Line : 1344 W REDONDO BEACH BLVD
Second Line :
City : GARDENA
State : CA
Zip : 90247-3356
Country : US
Telephone Number : 310-353-5726
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2022
Last Update Date : 11/15/2022

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Directions to “ NIKITA MAINALY PHARMD” Practice Location

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