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General NPI Number Information
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NPI Number | 1265909527
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Entity Type | Individual
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Provider Name | JEFFREY L MCBATH PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 10/25/2018
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Last Update Date | 10/25/2018
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Provider Practice Location Address
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Address Line | 9449 SAN FERNANDO RD
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City | SUN VALLEY
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State | CA
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Zip | 91352-1421
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Country | US
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Telephone | 818-252-2264
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3133
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City | BURBANK
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State | CA
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Zip | 91508-3133
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Country | US
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Telephone | 818-425-1485
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Fax |
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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 | 52423
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License Number State | CA
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