Healthcare Provider Details

I. General information

NPI: 1396128443
Provider Name (Legal Business Name): DSY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2015
Last Update Date: 07/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9171 WILSHIRE BLVD STE B
BEVERLY HILLS CA
90210-5530
US

IV. Provider business mailing address

9171 WILSHIRE BLVD STE B
BEVERLY HILLS CA
90210-5530
US

V. Phone/Fax

Practice location:
  • Phone: 310-385-9128
  • Fax: 310-385-9129
Mailing address:
  • Phone: 310-385-9128
  • Fax: 310-385-9129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY 53429
License Number StateCA

VIII. Authorized Official

Name: DR. SAHAR SIMINO
Title or Position: SECRETARY/PHARMACIST IN CHARGE
Credential: PHARM D
Phone: 310-385-9128