Healthcare Provider Details

I. General information

NPI: 1801704051
Provider Name (Legal Business Name): RAHUL KUMAR PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 S DE LACEY AVE APT 1000
PASADENA CA
91105-4521
US

IV. Provider business mailing address

1120 S GRAND AVE STE 103
LOS ANGELES CA
90015-4677
US

V. Phone/Fax

Practice location:
  • Phone: 626-844-5000
  • Fax: 626-844-5000
Mailing address:
  • Phone: 213-745-5000
  • Fax: 213-745-5000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number65041
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: