MEDICARE: DR. ASHKAN SHAWN KOHANPOUR PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	56067	CA

General Provider Information

NPI Number	:	1235162678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHKAN SHAWN KOHANPOUR PHARM.D.

Provider Business Mailing Address
First Line	:	10844 WASHINGTON BLVD
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90232-3610
Country	:	US
Telephone Number	:	310-559-5555
Fax Number	:	310-559-5553

Provider Business Practice Location Address
First Line	:	10844 WASHINGTON BLVD
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90232-3610
Country	:	US
Telephone Number	:	310-559-5555
Fax Number	:	310-559-5553

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	09/08/2016

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