MEDICARE: BBK GLOBAL CORP

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	333600000X	Pharmacy
2	3336C0004X	Compounding Pharmacy
3	3336C0003X	Community/Retail Pharmacy	50192	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2124012	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457674426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BBK GLOBAL CORP

Provider Business Mailing Address
First Line	:	11670 SAN VICENTE BLVD
Second Line	:	SUITE A
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-5121
Country	:	US
Telephone Number	:	310-826-1111
Fax Number	:	310-826-1115

Provider Business Practice Location Address
First Line	:	11670 SAN VICENTE BLVD STE A
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-5127
Country	:	US
Telephone Number	:	310-826-1111
Fax Number	:	310-826-1115

Authorized Official
Title or Position	:	OWNER, PHARMACIST IN CHARGE
Name	:	BEHDAD KADKHODA
Credential	:	RPH
Telephone Number	:	310-826-1111

Provider Enumeration Date	:	03/05/2010
Last Update Date	:	12/30/2021

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Directions to “BBK GLOBAL CORP ” Practice Location

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