Healthcare Provider Details

I. General information

NPI: 1801708631
Provider Name (Legal Business Name): ITZANAMI OSORIO PHARMD.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 S SAN VICENTE BLVD FL 7
LOS ANGELES CA
90048-3311
US

IV. Provider business mailing address

3333 W 2ND ST APT 51-101
LOS ANGELES CA
90004-6113
US

V. Phone/Fax

Practice location:
  • Phone: 224-201-5487
  • Fax:
Mailing address:
  • Phone: 224-201-5487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number92641
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: