Healthcare Provider Details

I. General information

NPI: 1215710637
Provider Name (Legal Business Name): MARJAN KASHEFI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2023
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 N ROXBURY DR
BEVERLY HILLS CA
90210-5001
US

IV. Provider business mailing address

PO BOX 241655
LOS ANGELES CA
90024-9455
US

V. Phone/Fax

Practice location:
  • Phone: 310-271-6123
  • Fax:
Mailing address:
  • Phone: 310-422-9678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number58810
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: