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General NPI Number Information
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NPI Number | 1457089690
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Entity Type | Individual
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Provider Name | SARA POPKO PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/14/2022
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Last Update Date | 08/14/2022
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Provider Practice Location Address
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Address Line | 17777 CENTER COURT DR N
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City | CERRITOS
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State | CA
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Zip | 90703-9320
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Country | US
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Telephone | 877-577-4844
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Fax |
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Provider Business Mailing Address
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Address Line | 2215 HARRIMAN LN APT B
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City | REDONDO BEACH
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State | CA
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Zip | 90278-4367
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Country | US
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Telephone | 347-562-8051
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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 | 85877
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License Number State | CA
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