Healthcare Provider Details

I. General information

NPI: 1144697285
Provider Name (Legal Business Name): RENU GAUR SARMA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2015
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3558 RUFFIN RD
SAN DIEGO CA
92123-2596
US

IV. Provider business mailing address

5264 TOPSAIL DR
SAN DIEGO CA
92154-8590
US

V. Phone/Fax

Practice location:
  • Phone: 858-627-5644
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number72875
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: