Healthcare Provider Details

I. General information

NPI: 1083690457
Provider Name (Legal Business Name): NAHED BAHLAWAN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL CAMP PENDLETON BUILDING H-100
CAMP PENDELTON CA
92055-5191
US

IV. Provider business mailing address

NAVAL HOSPITAL CAMP PENDLETON BUILDING H-100
CAMP PENDLETON CA
92055-5191
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-3492
  • Fax:
Mailing address:
  • Phone: 760-725-3492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number49909
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: