=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407252166
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PHARMACY PARTNERS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/07/2014
-----------------------------------------------------
Last Update Date | 03/11/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2490 HONOLULU AVE SUITE 110
-----------------------------------------------------
City | MONTROSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91020-1800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-330-7031
-----------------------------------------------------
Fax | 818-330-9526
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2490 HONOLULU AVE SUITE 110
-----------------------------------------------------
City | MONTROSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91020-1800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-330-7031
-----------------------------------------------------
Fax | 818-330-9526
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. EDWIN SHAKHMALIAN
-----------------------------------------------------
Credential | PHARM D
-----------------------------------------------------
Telephone | 818-330-7031
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PHY52050
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------