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General NPI Number Information
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NPI Number | 1689399255
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Entity Type | Individual
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Provider Name | KENNETH RAYMOND QUAN PHARMD, RPH
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Gender | Male
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Dates
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Enumeration Date | 10/06/2022
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 2510 EL CAMINO REAL
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City | CARLSBAD
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State | CA
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Zip | 92008-1273
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Country | US
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Telephone | 760-729-8941
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Fax |
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Provider Business Mailing Address
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Address Line | 14781 POMERADO RD # 122
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City | POWAY
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State | CA
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Zip | 92064-2802
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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 | 86919
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License Number State | CA
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