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General NPI Number Information
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NPI Number | 1023219664
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Entity Type | Organization
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Legal Business Name | IMPERIAL OF WESTWOOD PHARMACY
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1820 WESTWOOD BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90025-4612
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Country | US
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Telephone | 310-475-6000
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Fax | 310-475-2890
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Provider Business Mailing Address
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Address Line | 1820 WESTWOOD BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90025-4612
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Country | US
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Telephone |
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Fax | 310-475-2890
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Authorized Official
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Title or Position | PHARMACIST
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Name | IRADJ YADEGAR
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Credential |
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Telephone | 310-475-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY36046
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License Number State | CA
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