Healthcare Provider Details

I. General information

NPI: 1457888075
Provider Name (Legal Business Name): MARINA FOOX RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8490 BEVERLY BLVD
LOS ANGELES CA
90048-3414
US

IV. Provider business mailing address

8490 BEVERLY BLVD
LOS ANGELES CA
90048-3414
US

V. Phone/Fax

Practice location:
  • Phone: 323-653-4616
  • Fax:
Mailing address:
  • Phone: 323-653-4616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number53731
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: