Healthcare Provider Details

I. General information

NPI: 1174850234
Provider Name (Legal Business Name): ANDREW KHOSHO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2009
Last Update Date: 11/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL CAMP PENDLETON H100 SANTA MARGARITA RD
APO AA
92055-5191
US

IV. Provider business mailing address

H100 SANTA MARGARITA ROAD NAVAL HOSPITAL CAMP PENDLETON
CAMP PENDLETON CA
92055-5191
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-9429
  • Fax:
Mailing address:
  • Phone: 760-725-3429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 62952
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: