Healthcare Provider Details
I. General information
NPI: 1619077260
Provider Name (Legal Business Name): CATHERINE CATURA PAISTE DOCTOR OF PHARMACY
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/24/2006
Last Update Date: 01/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11301 WILSHIRE BLVD
LOS ANGELES CA
90073-1003
US
IV. Provider business mailing address
12621 WASHINGTON PL 102
LOS ANGELES CA
90066-4870
US
V. Phone/Fax
- Phone: 310-268-3244
- Fax:
- Phone: 310-980-1705
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 51407 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: