MEDICARE: MS. ROYA AMIRI 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	333600000X	Pharmacy		CA

General Provider Information

NPI Number	:	1891334892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROYA AMIRI PHARM D

Provider Business Mailing Address
First Line	:	171 PIER AVE # 468
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-5311
Country	:	US
Telephone Number	:	310-906-9819
Fax Number	:

Provider Business Practice Location Address
First Line	:	171 PIER AVE # 468
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-5311
Country	:	US
Telephone Number	:	310-906-9819
Fax Number	:

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

Provider Enumeration Date	:	12/23/2019
Last Update Date	:	12/23/2019

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