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General NPI Number Information
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NPI Number | 1861724403
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Entity Type | Individual
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Provider Name | KELLY HAN PHARMACIST
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Gender | Female
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Dates
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Enumeration Date | 02/08/2010
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 43500 RIDGE PARK DR
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City | TEMECULA
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State | CA
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Zip | 92590-3624
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Country | US
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Telephone | 302-559-8640
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Fax |
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Provider Business Mailing Address
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Address Line | 200 MERCY CIRCLE
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City | OCEANSIDE
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State | CA
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Zip | 92055
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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 | A10003951
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License Number State | DE
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