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NPI Code Detail

MEDICARE: PRIYANKA KOTHIA

MEDICARE: PRIYANKA KOTHIA
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
1183500000XPharmacist62453CA

General Provider Information

NPI Number : 1710331228
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRIYANKA KOTHIA
Provider Business Mailing Address
First Line : 3440 LA SIERRA AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92503-5204
Country : US
Telephone Number : 951-352-1933
Fax Number :
Provider Business Practice Location Address
First Line : 3440 LA SIERRA AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92503-5204
Country : US
Telephone Number : 951-352-1933
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2016
Last Update Date : 04/20/2016

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Directions to “ PRIYANKA KOTHIA ” Practice Location

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