MEDICARE: OBK LLC

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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1912630344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OBK LLC

Provider Business Mailing Address
First Line	:	1141 W REDONDO BEACH BLVD STE 100
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90247-3585
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1141 W REDONDO BEACH BLVD STE 100
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90247-3585
Country	:	US
Telephone Number	:	310-515-1881
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ARMIN KAHEN
Credential	:
Telephone Number	:	310-515-1881

Provider Enumeration Date	:	07/04/2022
Last Update Date	:	07/04/2022

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Directions to “OBK LLC ” Practice Location

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