Healthcare Provider Details

I. General information

NPI: 1679165484
Provider Name (Legal Business Name): RA INVESTMENT CAPITAL,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2021
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 S LA CIENEGA BLVD STE 105
LOS ANGELES CA
90035-2686
US

IV. Provider business mailing address

1080 S LA CIENEGA BLVD STE 105
LOS ANGELES CA
90035-2686
US

V. Phone/Fax

Practice location:
  • Phone: 310-704-7999
  • Fax:
Mailing address:
  • Phone: 310-704-7999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RUBEN AKHAMZADEH
Title or Position: PRESIDENT/CEO
Credential: PHARM D
Phone: 310-704-7999