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General NPI Number Information
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NPI Number | 1548514961
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Entity Type | Organization
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Legal Business Name | RANCHO HAVEN CARE LLC
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Dates
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Enumeration Date | 11/07/2012
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Last Update Date | 11/22/2025
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Provider Practice Location Address
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Address Line | 9170 HAVEN AVE STE 122
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-5416
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Country | US
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Telephone | 909-989-2899
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Fax | 909-945-5443
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Provider Business Mailing Address
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Address Line | 9170 HAVEN AVE STE 122
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-5416
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Country | US
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Telephone | 909-989-2899
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Fax | 909-945-5443
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Authorized Official
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Title or Position | CEO
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Name | GOPAL D SOJITRA
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Credential |
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Telephone | 909-764-3060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 51991
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License Number State | CA
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