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General NPI Number Information
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NPI Number | 1508671900
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Entity Type | Individual
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Provider Name | KATHRYN LEAH MIRZA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 4077 FIFTH AVE
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City | SAN DIEGO
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State | CA
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Zip | 92103-2105
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Country | US
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Telephone | 858-832-2478
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Fax |
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Provider Business Mailing Address
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Address Line | 3257 W OLIVE AVE APT 1E
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City | CHICAGO
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State | IL
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Zip | 60659-3682
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 89521
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License Number State | CA
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