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General NPI Number Information
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NPI Number | 1629423348
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Entity Type | Individual
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Provider Name | SOHAIL KHODABAKHSHI PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 05/02/2016
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Last Update Date | 05/02/2016
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Provider Practice Location Address
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Address Line | 747 WESTWOOD PLAZA
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City | LOS ANGELES
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State | CA
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Zip | 90095
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Country | US
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Telephone | 310-267-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 10905 OHIO AVENUE APT 312
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City | LOS ANGELES
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State | CA
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Zip | 90024
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Country | US
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Telephone | 901-335-1592
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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 | 72878
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License Number State | CA
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