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General NPI Number Information
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NPI Number | 1972725307
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Entity Type | Individual
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Provider Name | JAGWANT RAI PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9350 CAMPUS POINT DRIVE PERLMAN AMBULATORY CARE PHARMACY
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City | LA JOLLA
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State | CA
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Zip | 92037-7729
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Country | US
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Telephone | 858-657-8610
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Fax |
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Provider Business Mailing Address
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Address Line | 13821 DURANGO DR
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City | DEL MAR
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State | CA
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Zip | 92014-3115
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Country | US
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Telephone | 858-259-4852
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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 | 45054
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License Number State | CA
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