Provider Demographics
NPI:1669792644
Name:KADUR, PRABHAKAR N (BS PHARMACY)
Entity type:Individual
Prefix:
First Name:PRABHAKAR
Middle Name:N
Last Name:KADUR
Suffix:
Gender:M
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20141 SHERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91306-3206
Mailing Address - Country:US
Mailing Address - Phone:818-882-4508
Mailing Address - Fax:818-882-4846
Practice Address - Street 1:20141 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91306-3206
Practice Address - Country:US
Practice Address - Phone:818-882-4508
Practice Address - Fax:818-882-4846
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39853183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist