Provider Demographics
NPI:1255002754
Name:BAWA, MOHINI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MOHINI
Middle Name:
Last Name:BAWA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19892 RED ROAN LN
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-7928
Mailing Address - Country:US
Mailing Address - Phone:714-272-0165
Mailing Address - Fax:
Practice Address - Street 1:19892 RED ROAN LN
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-7928
Practice Address - Country:US
Practice Address - Phone:714-272-0165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH815661835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care