Healthcare Provider Details

I. General information

NPI: 1720587199
Provider Name (Legal Business Name): ARCHANA VACHHANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2018
Last Update Date: 02/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11930 STUDEBAKER RD
NORWALK CA
90650-7548
US

IV. Provider business mailing address

10563 ACACIA LN
SANTA FE SPRINGS CA
90670-3882
US

V. Phone/Fax

Practice location:
  • Phone: 562-864-8238
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number77429
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: