Healthcare Provider Details

I. General information

NPI: 1164757977
Provider Name (Legal Business Name): CURTIS L POLLARD CPHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2009
Last Update Date: 10/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23357 PACIFIC COAST HWY
MALIBU CA
90265-4957
US

IV. Provider business mailing address

4833 HAZELTINE AVE SUITE 4
SHERMAN OAKS CA
91423-2342
US

V. Phone/Fax

Practice location:
  • Phone: 310-456-9059
  • Fax:
Mailing address:
  • Phone: 818-237-5296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number76256
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: