MEDICARE: JANET AHADI 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	RPH46339	CA

General Provider Information

NPI Number	:	1366807331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET AHADI PHARM.D

Provider Business Mailing Address
First Line	:	540 TUALLITAN RD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-1943
Country	:	US
Telephone Number	:	310-991-6155
Fax Number	:	310-479-0220

Provider Business Practice Location Address
First Line	:	11504 SANTA MONICA BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-3008
Country	:	US
Telephone Number	:	310-479-0200
Fax Number	:

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

Provider Enumeration Date	:	12/17/2015
Last Update Date	:	12/17/2015

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