MEDICARE: DEBRA NOELLE KAW PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	69113	CA

General Provider Information

NPI Number	:	1013341668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA NOELLE KAW PHARMD

Provider Business Mailing Address
First Line	:	774 VIA COLINAS
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-5060
Country	:	US
Telephone Number	:	703-407-9428
Fax Number	:

Provider Business Practice Location Address
First Line	:	3941 SPRING RD
Second Line	:
City	:	MOORPARK
State	:	CA
Zip	:	93021-2300
Country	:	US
Telephone Number	:	805-529-5726
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2013
Last Update Date	:	08/29/2013

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