MEDICARE: RAHEEL MIR RPH, 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	RPH89165	CA
2	183500000X	Pharmacist	PH240137	MA

General Provider Information

NPI Number	:	1780253088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAHEEL MIR RPH, PHARMD

Provider Business Mailing Address
First Line	:	17530 HAWTHORNE BLVD
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90504-3110
Country	:	US
Telephone Number	:	310-921-8356
Fax Number	:

Provider Business Practice Location Address
First Line	:	17530 HAWTHORNE BLVD
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90504-3110
Country	:	US
Telephone Number	:	310-921-8356
Fax Number	:

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

Provider Enumeration Date	:	06/21/2021
Last Update Date	:	03/03/2026

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