Healthcare Provider Details

I. General information

NPI: 1669421640
Provider Name (Legal Business Name): APOTEK GLOBAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 03/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 E COAST HWY SUITE 150
CORONA DEL MAR CA
92625-2236
US

IV. Provider business mailing address

2865 E COAST HWY SUITE 150
CORONA DEL MAR CA
92625-2236
US

V. Phone/Fax

Practice location:
  • Phone: 949-644-7575
  • Fax: 949-644-2340
Mailing address:
  • Phone: 949-644-7575
  • Fax: 949-644-2340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY53635
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License NumberPHY53635
License Number StateCA

VIII. Authorized Official

Name: DR. LALEH TAHERI
Title or Position: CEO
Credential: PHARM. D
Phone: 949-644-7575