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General NPI Number Information
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NPI Number | 1609487289
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Entity Type | Individual
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Provider Name | TANNER PACE SAFIR
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Gender | Male
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Dates
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Enumeration Date | 08/16/2020
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 43112 15TH ST W
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City | LANCASTER
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State | CA
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Zip | 93534-6219
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Country | US
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Telephone | 833-574-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 3900 SAN FERNANDO RD APT 1321
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City | GLENDALE
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State | CA
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Zip | 91204-2863
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Country | US
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Telephone | 619-541-2089
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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 | 90609
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License Number State | CA
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