Healthcare Provider Details

I. General information

NPI: 1669312542
Provider Name (Legal Business Name): KYLE DALAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 PEBBLE CREEK LN
WALNUT CA
91789-4550
US

IV. Provider business mailing address

940 PEBBLE CREEK LN
WALNUT CA
91789-4550
US

V. Phone/Fax

Practice location:
  • Phone: 626-347-0643
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number91743
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: