Healthcare Provider Details

I. General information

NPI: 1053556811
Provider Name (Legal Business Name): JENNIFER SLEVIN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER MAK SLEVIN PHARM.D.

II. Dates (important events)

Enumeration Date: 12/09/2008
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4676 ADMIRALTY WAY FL 4
MARINA DEL REY CA
90292-6601
US

IV. Provider business mailing address

4676 ADMIRALTY WAY FL 4
MARINA DEL REY CA
90292-6601
US

V. Phone/Fax

Practice location:
  • Phone: 310-385-3534
  • Fax: 310-248-7022
Mailing address:
  • Phone: 310-385-3534
  • Fax: 310-248-7022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number60200
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: