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General NPI Number Information
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NPI Number | 1316937675
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Entity Type | Individual
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Provider Name | RAJ MISTRY RPH
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Gender | Male
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 3180 E FLORENCE AVE
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-5830
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Country | US
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Telephone | 323-583-4307
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Fax | 323-583-0900
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Provider Business Mailing Address
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Address Line | 3180 E FLORENCE AVE
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-5830
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Country | US
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Telephone | 323-583-4307
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Fax | 323-583-0900
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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 | RPH38454
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License Number State | CA
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