Kulsum Sabeen Ahmad, RPH

Individual provider Active NPI Pharmacist · Blue Jay, CA

NPI 1043078728 · NPPES record last updated Mar 7, 2024

Key facts

NPI
1043078728
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
89223 (CA)
Practice address
27177 State Highway 189
Blue Jay, CA 92317-0017
Phone
(909) 336-1275
NPI assigned
Mar 7, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
89223CAMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 89223 CA Yes

Addresses

Primary practice location

27177 State Highway 189
Blue Jay, CA 92317-0017

Mailing address

PO Box 366
Lake Arrowhead, CA 92352-0366
Phone (909) 557-4755

Other providers in Blue Jay, CA

All providers in Blue Jay, CA · Pharmacist in California

Sources for this page

Verify at the official NPI Registry.