=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427853761
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EBRU KAHYAOGLU PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/19/2025
-----------------------------------------------------
Last Update Date | 02/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 33205 TEMECULA PKWY
-----------------------------------------------------
City | TEMECULA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92592-9142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-303-3164
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2171 W CRESTWOOD LN
-----------------------------------------------------
City | ANAHEIM
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92804-6439
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-833-7917
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 55046
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------