Provider Demographics
NPI:1699044875
Name:KITSAWADI, NIRAMOL (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:NIRAMOL
Middle Name:
Last Name:KITSAWADI
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11833 THUNDERBIRD AVE
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-1451
Mailing Address - Country:US
Mailing Address - Phone:818-317-9754
Mailing Address - Fax:
Practice Address - Street 1:11833 THUNDERBIRD AVE
Practice Address - Street 2:
Practice Address - City:PORTER RANCH
Practice Address - State:CA
Practice Address - Zip Code:91326-1451
Practice Address - Country:US
Practice Address - Phone:818-317-9754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-18
Last Update Date:2011-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58468183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist