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NPI Code Detail

MEDICARE: DR. RACHEL KYLEY MASHBURN PHARM. D.

MEDICARE: DR. RACHEL KYLEY MASHBURN PHARM. D.
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
1183500000XPharmacist60278CA

General Provider Information

NPI Number : 1376732172
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RACHEL KYLEY MASHBURN PHARM. D.
Provider Business Mailing Address
First Line : 100 N CLARK DR APT 402
Second Line :
City : WEST HOLLYWOOD
State : CA
Zip : 90048-6303
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1985 ZONAL AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90089-5305
Country : US
Telephone Number : 949-521-1857
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2007
Last Update Date : 10/17/2007

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