Healthcare Provider Details

I. General information

NPI: 1043447204
Provider Name (Legal Business Name): DR N VAHEDI PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2009
Last Update Date: 02/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 WESTWOOD BLVD STE A
LOS ANGELES CA
90025-6328
US

IV. Provider business mailing address

2001 WESTWOOD BLVD STE A
LOS ANGELES CA
90025-6328
US

V. Phone/Fax

Practice location:
  • Phone: 310-204-6676
  • Fax: 310-204-6678
Mailing address:
  • Phone: 310-204-6676
  • Fax: 310-204-6678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPHY49937
License Number StateCA

VIII. Authorized Official

Name: NAVID VAHEDI
Title or Position: PHARMACIST/OWNER
Credential:
Phone: 310-877-9393