Provider Demographics
NPI:1992026850
Name:MOTWANI, NANDLAL (RPH)
Entity Type:Individual
Prefix:MR
First Name:NANDLAL
Middle Name:
Last Name:MOTWANI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3236 HONOLULU AVE
Mailing Address - Street 2:103
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91214-4114
Mailing Address - Country:US
Mailing Address - Phone:818-541-9031
Mailing Address - Fax:
Practice Address - Street 1:10811 ZELZAH AVE
Practice Address - Street 2:RITE AID
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-4433
Practice Address - Country:US
Practice Address - Phone:818-368-7233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42995183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist