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NPI Code Detail

MEDICARE: DR. JAIRUS K MAHOE PHARMD

MEDICARE: DR. JAIRUS K MAHOE 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
1183500000XPharmacist75920CA

General Provider Information

NPI Number : 1255871638
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAIRUS K MAHOE PHARMD
Provider Business Mailing Address
First Line : 9610 RIDGEHAVEN CT STE C
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-5603
Country : US
Telephone Number : 619-543-7453
Fax Number : 858-268-5019
Provider Business Practice Location Address
First Line : 9610 RIDGEHAVEN CT STE C
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-5603
Country : US
Telephone Number : 619-543-7453
Fax Number : 858-268-5019
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2017
Last Update Date : 04/02/2026

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