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General NPI Number Information
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NPI Number | 1568051183
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Entity Type | Organization
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Legal Business Name | MASTERS COMPOUNDING PHARMACY, INC.
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Dates
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Enumeration Date | 01/18/2021
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Last Update Date | 01/18/2021
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Provider Practice Location Address
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Address Line | 8600 W 3RD ST STE 1
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City | LOS ANGELES
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State | CA
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Zip | 90048-3338
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Country | US
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Telephone | 424-235-4210
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Fax |
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Provider Business Mailing Address
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Address Line | 8600 W 3RD ST STE 1
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City | LOS ANGELES
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State | CA
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Zip | 90048-3338
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Country | US
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Telephone | 424-235-4210
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Fax |
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Authorized Official
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Title or Position | CEO/DIRECTOR
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Name | MOUSA MIRAKHOR KALIMI
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Credential |
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Telephone | 310-978-6785
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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 |
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License Number State |
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