Healthcare Provider Details

I. General information

NPI: 1699084459
Provider Name (Legal Business Name): FELICE R SANDERS-KEYS RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2010
Last Update Date: 09/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 SEPULVEDA BLVD
TORRANCE CA
90501-5301
US

IV. Provider business mailing address

17815 PALM CT
CARSON CA
90746-7426
US

V. Phone/Fax

Practice location:
  • Phone: 310-325-0868
  • Fax: 310-325-2882
Mailing address:
  • Phone: 310-764-5640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 48320
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: