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General NPI Number Information
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NPI Number | 1831817303
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Entity Type | Individual
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Provider Name | JEMY RAJAN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/19/2022
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | 16858 GOLDEN VALLEY PKWY
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City | LATHROP
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State | CA
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Zip | 95330-9240
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Country | US
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Telephone | 209-242-5042
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Fax |
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Provider Business Mailing Address
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Address Line | 2050 JENNI LN
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City | TRACY
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State | CA
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Zip | 95377-9502
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Country | US
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Telephone | 209-232-5333
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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 | RPH86077
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License Number State | CA
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