Organization
PRAVIN DARJI
Active
Other names
MORENO VALLEY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PRAVIN DARJI BS PHARMACY (OWNER)
(951) 485-6500
Entity
Organization
Contact information
Practice address
12980 FREDERICK ST STE B, MORENO VALLEY, CA 92553-5263
(909) 485-6500
(951) 247-3797
Mailing address
12980 FREDERICK ST STE B, MORENO VALLEY, CA 92553-5263
(909) 485-6500
(951) 247-3797
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY40564
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1993987
PK
—
05
—
PHA405640
—
CA
Enumeration date
08/20/2006
Last updated
09/19/2025
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