=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508332578
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SEBASTIAN ZAPART PHARMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/17/2018
-----------------------------------------------------
Last Update Date | 10/17/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18 TECHNOLOGY DR STE 104
-----------------------------------------------------
City | IRVINE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92618-5303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-471-0223
-----------------------------------------------------
Fax | 949-404-3759
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25171 CHESHIRE
-----------------------------------------------------
City | MISSION VIEJO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92692-2846
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-215-7020
-----------------------------------------------------
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 | 59562
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------