Healthcare Provider Details

I. General information

NPI: 1801710835
Provider Name (Legal Business Name): TARIQ PULSKAMP PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N MISSION RD
LOS ANGELES CA
90033-1021
US

IV. Provider business mailing address

3433 PASADENA AVE APT 131
LOS ANGELES CA
90031-2690
US

V. Phone/Fax

Practice location:
  • Phone: 323-409-8255
  • Fax:
Mailing address:
  • Phone: 661-331-1174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number92454
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: