MEDICARE: AVNEET KAUR

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	87137	CA

General Provider Information

NPI Number	:	1245956887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AVNEET KAUR

Provider Business Mailing Address
First Line	:	20710 CALLE PERA
Second Line	:
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-4638
Country	:	US
Telephone Number	:	562-235-2843
Fax Number	:

Provider Business Practice Location Address
First Line	:	19701 YORBA LINDA BLVD
Second Line	:
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-3532
Country	:	US
Telephone Number	:	562-235-2843
Fax Number	:

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

Provider Enumeration Date	:	10/14/2022
Last Update Date	:	10/14/2022

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