MEDICARE: NEDA KALALI PHARM.D., MHSA

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	RPH80071	CA

General Provider Information

NPI Number	:	1184288946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEDA KALALI PHARM.D., MHSA

Provider Business Mailing Address
First Line	:	28945 OAK CREEK LN APT 2104
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-6447
Country	:	US
Telephone Number	:	818-307-0972
Fax Number	:

Provider Business Practice Location Address
First Line	:	28945 OAK CREEK LN APT 2104
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-6447
Country	:	US
Telephone Number	:	818-307-0972
Fax Number	:

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

Provider Enumeration Date	:	04/26/2019
Last Update Date	:	04/26/2019

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