Healthcare Provider Details

I. General information

NPI: 1538718838
Provider Name (Legal Business Name): XPRESS MED PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2019
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16929 BUSHARD ST
FOUNTAIN VALLEY CA
92708-2819
US

IV. Provider business mailing address

16929 BUSHARD ST
FOUNTAIN VALLEY CA
92708-2819
US

V. Phone/Fax

Practice location:
  • Phone: 714-790-0119
  • Fax: 714-369-2497
Mailing address:
  • Phone: 714-790-0119
  • Fax: 714-369-2497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. MAHBOD ZARGAR
Title or Position: SECRETARY/ RPH
Credential: PHARM D
Phone: 714-790-0119