Healthcare Provider Details

I. General information

NPI: 1679898654
Provider Name (Legal Business Name): ROBERT VINCENT MULBRECHT PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2010
Last Update Date: 04/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4867 W SUNSET BLVD KAISER MEDICAL CENTER, INPATIENT PHARMACY
LOS ANGELES CA
90027-5969
US

IV. Provider business mailing address

4867 W SUNSET BLVD KAISER MEDICAL CENTER, INPATIENT PHARMACY
LOS ANGELES CA
90027-5969
US

V. Phone/Fax

Practice location:
  • Phone: 323-783-9700
  • Fax: 323-783-4920
Mailing address:
  • Phone: 323-783-9700
  • Fax: 323-783-4920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH 29322
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number5302021605
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: