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General NPI Number Information
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NPI Number | 1538677083
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Entity Type | Organization
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Legal Business Name | CITY CARE PHARMACY, INC.
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Dates
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Enumeration Date | 01/18/2018
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Last Update Date | 02/20/2018
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Provider Practice Location Address
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Address Line | 648 E 21ST ST STE 102
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City | LOS ANGELES
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State | CA
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Zip | 90011-1146
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Country | US
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Telephone | 213-275-1880
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Fax | 213-275-1849
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Provider Business Mailing Address
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Address Line | 2355 WESTWOOD BLVD # 186
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City | LOS ANGELES
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State | CA
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Zip | 90064-2109
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Country | US
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Telephone | 818-335-1020
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Fax |
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Authorized Official
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Title or Position | CEO/PIC
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Name | DR. DANIEL ABRAHAM SABZEROU
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Credential | PHARM.D.
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Telephone | 213-275-1880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 55877
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License Number State | CA
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