Healthcare Provider Details

I. General information

NPI: 1538205216
Provider Name (Legal Business Name): J B FAR INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 03/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2699 E FLORENCE AVE
HUNTINGTON PARK CA
90255-4747
US

IV. Provider business mailing address

2699 E FLORENCE AVE
HUNTINGTON PARK CA
90255-4747
US

V. Phone/Fax

Practice location:
  • Phone: 323-582-6078
  • Fax: 323-582-0833
Mailing address:
  • Phone: 323-582-6078
  • Fax: 323-582-0833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number51721
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: YOUSEF BAHDI
Title or Position: OWNER, AO
Credential:
Phone: 323-582-6078