Provider Demographics
NPI:1497533970
Name:KAUSHAL, RAMAN K
Entity Type:Individual
Prefix:
First Name:RAMAN
Middle Name:K
Last Name:KAUSHAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9715 OTIS ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-4997
Mailing Address - Country:US
Mailing Address - Phone:323-566-1198
Mailing Address - Fax:
Practice Address - Street 1:9715 OTIS ST
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-4997
Practice Address - Country:US
Practice Address - Phone:323-566-1198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88459183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist