Provider Demographics
NPI:1720737117
Name:KACHOUEI, FARRNAM HARLANG (PHARMD)
Entity Type:Individual
Prefix:
First Name:FARRNAM
Middle Name:HARLANG
Last Name:KACHOUEI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 E TAM O SHANTER ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-6455
Mailing Address - Country:US
Mailing Address - Phone:909-851-5224
Mailing Address - Fax:
Practice Address - Street 1:2011 E TAM O SHANTER ST
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-6455
Practice Address - Country:US
Practice Address - Phone:909-851-5224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82002183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist