Healthcare Provider Details

I. General information

NPI: 1912533324
Provider Name (Legal Business Name): MAGY SAMIR ESKANDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2020
Last Update Date: 03/17/2020
Certification Date: 03/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BLVD
WEST HOLLYWOOD CA
90048-1804
US

IV. Provider business mailing address

127 S SAN VICENTE BLVD # A2411
LOS ANGELES CA
90048-3311
US

V. Phone/Fax

Practice location:
  • Phone: 310-967-7602
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number82160
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: