Healthcare Provider Details

I. General information

NPI: 1184860801
Provider Name (Legal Business Name): FOBI COMPREHENSIVE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2008
Last Update Date: 10/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7922 ROSECRANS AVE STE P2
PARAMOUNT CA
90723-6009
US

IV. Provider business mailing address

PO BOX 1990
LOMITA CA
90717-5990
US

V. Phone/Fax

Practice location:
  • Phone: 562-630-5700
  • Fax: 562-630-5705
Mailing address:
  • Phone: 562-630-5700
  • Fax: 562-630-5705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number489288
License Number StateCA

VIII. Authorized Official

Name: WILLIAM FOBI
Title or Position: PRESIDENT
Credential:
Phone: 323-731-8414