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General NPI Number Information
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NPI Number | 1053861088
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Entity Type | Individual
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Provider Name | LOVEDEEP BAINS PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/13/2016
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Last Update Date | 10/13/2016
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Provider Practice Location Address
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Address Line | 15240 S HARLAN RD
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City | LATHROP
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State | CA
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Zip | 95330-9754
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Country | US
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Telephone | 209-858-4798
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Fax |
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Provider Business Mailing Address
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Address Line | 3044 SOTO CT
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City | TRACY
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State | CA
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Zip | 95377-7983
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 75546
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License Number State | CA
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