Healthcare Provider Details

I. General information

NPI: 1104025626
Provider Name (Legal Business Name): ZELZAH PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17911 VENTURA BLVD
ENCINO CA
91316-3618
US

IV. Provider business mailing address

17911 VENTURA BLVD
ENCINO CA
91316-3618
US

V. Phone/Fax

Practice location:
  • Phone: 818-609-0692
  • Fax: 818-609-0170
Mailing address:
  • Phone: 818-609-0692
  • Fax: 818-609-0170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ABE JAVAHERI
Title or Position: PRESIDENT/CEO
Credential: PHARM D
Phone: 818-609-0692