Healthcare Provider Details

I. General information

NPI: 1982940946
Provider Name (Legal Business Name): ANNA SHPILBERG RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2012
Last Update Date: 12/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4940 VAN NUYS BLVD 104
SHERMAN OAKS CA
91403-1700
US

IV. Provider business mailing address

17110 CLEMONS DR
ENCINO CA
91436-4026
US

V. Phone/Fax

Practice location:
  • Phone: 818-990-3784
  • Fax: 818-990-1862
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number48620
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: