Healthcare Provider Details

I. General information

NPI: 1982754727
Provider Name (Legal Business Name): SUNSET CENTER PHARMACY,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5137 W SUNSET BLVD
LOS ANGELES CA
90027-5715
US

IV. Provider business mailing address

5137 1/2 W SUNSET BLVD
LOS ANGELES CA
90027-5715
US

V. Phone/Fax

Practice location:
  • Phone: 323-664-1882
  • Fax: 323-664-1809
Mailing address:
  • Phone: 323-664-1882
  • Fax: 323-664-1809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. MARDIROS BASTEGUIAN
Title or Position: PRESIDENT
Credential:
Phone: 323-664-1882