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General NPI Number Information
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NPI Number | 1053628875
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Entity Type | Individual
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Provider Name | SOHEYLA SOURY RPH
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Gender | Female
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Dates
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Enumeration Date | 09/01/2010
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Last Update Date | 09/01/2010
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Provider Practice Location Address
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Address Line | 1841 N WESTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90027-3403
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Country | US
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Telephone | 323-461-6136
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Fax | 323-461-1633
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Provider Business Mailing Address
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Address Line | 1841 NORTH WESTERN AVE.
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City | LOS ANGELES
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State | CA
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Zip | 90027
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Country | US
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Telephone | 323-461-6136
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Fax | 323-461-1633
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 63341
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License Number State | CA
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