MEDICARE: TANIA RAWAS

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
1	183500000X	Pharmacist	76246	CA

General Provider Information

NPI Number	:	1710557566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANIA RAWAS

Provider Business Mailing Address
First Line	:	4015 CROWN POINT DR UNIT 110
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-6210
Country	:	US
Telephone Number	:	513-382-7788
Fax Number	:

Provider Business Practice Location Address
First Line	:	4015 CROWN POINT DR UNIT 110
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-6210
Country	:	US
Telephone Number	:	513-382-7788
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2021
Last Update Date	:	06/24/2021

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Directions to “ TANIA RAWAS ” Practice Location

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