Healthcare Provider Details

I. General information

NPI: 1114256559
Provider Name (Legal Business Name): AMARJIT SINGH AHLUWALIA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2009
Last Update Date: 12/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9133 KIEFER BLVD
SACRAMENTO CA
95826-5105
US

IV. Provider business mailing address

4001 S WATT AVE SUITE 216
SACRAMENTO CA
95826-4463
US

V. Phone/Fax

Practice location:
  • Phone: 916-366-1377
  • Fax: 916-366-7861
Mailing address:
  • Phone: 916-366-1377
  • Fax: 916-366-7861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH45019
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: