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General NPI Number Information
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NPI Number | 1184017915
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Entity Type | Individual
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Provider Name | CULLEN NAGATANI
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Gender | Male
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Dates
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Enumeration Date | 03/18/2015
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Last Update Date | 11/17/2023
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Provider Practice Location Address
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Address Line | 12 W HANFORD ARMONA RD
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City | LEMOORE
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State | CA
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Zip | 93245-2320
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Country | US
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Telephone | 559-925-6510
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Fax | 559-925-6517
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Provider Business Mailing Address
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Address Line | 10400 W CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89135-1035
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Country | US
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Telephone | 702-562-3169
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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 | 72418
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 20135
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License Number State | NV
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