MEDICARE: KALEENA ENANY 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	28R103585300	NJ
2	183500000X	Pharmacist	058977	NY
3	183500000X	Pharmacist	PCT.0012798	CT
4	183500000X	Pharmacist	70562	CA

General Provider Information

NPI Number	:	1912324260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALEENA ENANY PHARMD

Provider Business Mailing Address
First Line	:	11270 LOS ALAMITOS BLVD
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3958
Country	:	US
Telephone Number	:	562-596-2729
Fax Number	:

Provider Business Practice Location Address
First Line	:	11270 LOS ALAMITOS BLVD
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3958
Country	:	US
Telephone Number	:	562-596-2729
Fax Number	:

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

Provider Enumeration Date	:	03/25/2014
Last Update Date	:	01/07/2021

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Directions to “ KALEENA ENANY PHARMD” Practice Location

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