Individual
MR. KEVIN J MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
555 S SUNRISE WAY, SUITE 112-113, PALM SPRINGS, CA 92264-7869
(760) 323-1973
(760) 320-5236
Mailing address
555 S SUNRISE WAY, SUITE 112-113, PALM SPRINGS, CA 92264-7869
(760) 323-1973
(760) 320-5236
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
54549
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689826042
—
CA
Enumeration date
11/04/2011
Last updated
11/04/2011
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