MEDICARE: MARINA VEYTSMAN RPH

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	50040	CA

General Provider Information

NPI Number	:	1740263607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARINA VEYTSMAN RPH

Provider Business Mailing Address
First Line	:	23958 CALVERT ST
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-1215
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15031 RINALDI ST
Second Line	:
City	:	MISSION HILLS
State	:	CA
Zip	:	91345-1207
Country	:	US
Telephone Number	:	818-898-4696
Fax Number	:

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

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	10/12/2008

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