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General NPI Number Information
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NPI Number | 1275365934
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Entity Type | Individual
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Provider Name | RYAN KAI KIRK PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/20/2024
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 147 N BRENT ST
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City | VENTURA
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State | CA
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Zip | 93003-2854
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Country | US
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Telephone | 805-948-8084
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Fax |
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Provider Business Mailing Address
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Address Line | 4323 VALLEY SPRING DR
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-4336
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Country | US
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Telephone | 805-657-9029
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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 | RPH80621
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License Number State | CA
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