Provider Demographics
NPI:1699066290
Name:KHOSLA, RAJESH (RPH)
Entity type:Individual
Prefix:
First Name:RAJESH
Middle Name:
Last Name:KHOSLA
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 1:10319 GRIZZLY ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9531
Mailing Address - Country:US
Mailing Address - Phone:661-303-7948
Mailing Address - Fax:
Practice Address - Street 1:10319 GRIZZLY ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9531
Practice Address - Country:US
Practice Address - Phone:661-303-7948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-29
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH63791183500000X
MEPR5681183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist