=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063855070
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MALTE IAN NAPP PHARM D
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2013
-----------------------------------------------------
Last Update Date | 05/05/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16111 PLUMMER STREET BUILDING 200 ROOM 1206
-----------------------------------------------------
City | NORTH HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91343
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-478-3711
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16111 PLUMMER STREET BUILDING 200 ROOM 1206
-----------------------------------------------------
City | NORTH HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91343
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-891-7711
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 69661
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------