Healthcare Provider Details

I. General information

NPI: 1104106921
Provider Name (Legal Business Name): ROSALIN KHUU PHARM D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2011
Last Update Date: 06/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1038 E COLORADO BLVD
PASADENA CA
91106-2323
US

IV. Provider business mailing address

2954 W VALLEY BLVD
ALHAMBRA CA
91803-1819
US

V. Phone/Fax

Practice location:
  • Phone: 626-796-5539
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number65939
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: