=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659774271
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YASIN AIT-OUYAHIA PHARM.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/28/2014
-----------------------------------------------------
Last Update Date | 09/28/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 60 N MOORPARK RD
-----------------------------------------------------
City | THOUSAND OAKS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91360-4454
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-496-9310
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 774 VIA COLINAS
-----------------------------------------------------
City | WESTLAKE VILLAGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91362-5060
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-734-8495
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 69084
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------