Healthcare Provider Details

I. General information

NPI: 1790062461
Provider Name (Legal Business Name): ANGELA LEE ZAGHI PHARM. D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2011
Last Update Date: 11/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14920 RAYMER ST T-1309
VAN NUYS CA
91405-1146
US

IV. Provider business mailing address

14920 RAYMER ST T-1309
VAN NUYS CA
91405-1146
US

V. Phone/Fax

Practice location:
  • Phone: 818-631-9118
  • Fax:
Mailing address:
  • Phone: 818-631-9118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number65859
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: