Healthcare Provider Details

I. General information

NPI: 1811270648
Provider Name (Legal Business Name): MELIKA SHABAN ESKALAEI RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2011
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18430 SHERMAN WAY
RESEDA CA
91335
US

IV. Provider business mailing address

4328 GENTRY AVE #3
STUDIO CA
91664
US

V. Phone/Fax

Practice location:
  • Phone: 818-343-4513
  • Fax:
Mailing address:
  • Phone: 818-632-0545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number61669
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: