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General NPI Number Information
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NPI Number | 1063240182
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Entity Type | Individual
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Provider Name | PULKIT JAIN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/22/2024
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 8700 BEVERLY BLVD
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90048-1804
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Country | US
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Telephone | 951-818-0005
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Fax |
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Provider Business Mailing Address
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Address Line | 942 W SIERRA NEVADA WAY
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City | ORANGE
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State | CA
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Zip | 92865-2011
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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 | 1835E0208X
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Taxonomy Name | Emergency Medicine Pharmacist
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License Number | 82403
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License Number State | CA
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