Provider Demographics
NPI:1558440941
Name:RAKHOLIA, RAMESH (RPH)
Entity Type:Individual
Prefix:MR
First Name:RAMESH
Middle Name:
Last Name:RAKHOLIA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:RAM
Other - Middle Name:
Other - Last Name:RAKHOLIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:6367 ALVARADO CT
Mailing Address - Street 2:SUITE 109
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-4904
Mailing Address - Country:US
Mailing Address - Phone:619-287-7697
Mailing Address - Fax:619-287-7698
Practice Address - Street 1:6367 ALVARADO CT
Practice Address - Street 2:SUITE 109
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-4904
Practice Address - Country:US
Practice Address - Phone:619-287-7697
Practice Address - Fax:619-287-7698
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH45640183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARPH45640OtherREGISTERED PHARMACIST