Healthcare Provider Details

I. General information

NPI: 1760493316
Provider Name (Legal Business Name): ADVANCED PHYSICANS SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 03/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7225 FULTON AVE
NORTH HOLLYWOOD CA
91605-4111
US

IV. Provider business mailing address

4335 VAN NUYS BLVD SUITE 407
SHERMAN OAKS CA
91403-3727
US

V. Phone/Fax

Practice location:
  • Phone: 818-982-2813
  • Fax: 866-219-2340
Mailing address:
  • Phone: 818-982-2813
  • Fax: 866-837-4530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY48591
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH KOHAN
Title or Position: CFO
Credential:
Phone: 310-922-0272