Healthcare Provider Details

I. General information

NPI: 1649590803
Provider Name (Legal Business Name): HANY SAMIR ESKANDAR PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 06/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1433 GLENDALE BLVD
LOS ANGELES CA
90026-2428
US

IV. Provider business mailing address

1433 GLENDALE BLVD
LOS ANGELES CA
90026-2428
US

V. Phone/Fax

Practice location:
  • Phone: 213-483-3468
  • Fax: 213-483-1031
Mailing address:
  • Phone: 213-483-3468
  • Fax: 213-483-1031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number56898
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: