Healthcare Provider Details

I. General information

NPI: 1609953041
Provider Name (Legal Business Name): STEVEN MARK ODA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4867 W SUNSET BLVD
LOS ANGELES CA
90027-5969
US

IV. Provider business mailing address

224 ELM ST
ALHAMBRA CA
91801-3007
US

V. Phone/Fax

Practice location:
  • Phone: 323-783-8300
  • Fax: 323-783-4622
Mailing address:
  • Phone: 626-281-5864
  • Fax: 323-783-4920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number38798
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: