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General NPI Number Information
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NPI Number | 1639869274
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Entity Type | Individual
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Provider Name | SLAVA STAROBINETS PHARM D.
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Gender | Male
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Dates
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Enumeration Date | 05/08/2023
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Last Update Date | 05/08/2023
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Provider Practice Location Address
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Address Line | 19300 S HAMILTON AVE STE 130
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City | GARDENA
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State | CA
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Zip | 90248-4418
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Country | US
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Telephone | 877-429-0708
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Fax |
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Provider Business Mailing Address
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Address Line | 415 E MISSION RD UNIT 12
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City | ALHAMBRA
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State | CA
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Zip | 91801-6116
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Country | US
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Telephone | 323-899-0624
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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 | 1835I0206X
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Taxonomy Name | Infectious Diseases Pharmacist
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License Number | 61205792
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1835I0206X
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Taxonomy Name | Infectious Diseases Pharmacist
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License Number | 72012
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License Number State | CA
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