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General NPI Number Information
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NPI Number | 1730231085
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Entity Type | Organization
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Legal Business Name | AURORA ALCANTARA
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 03/08/2010
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Provider Practice Location Address
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Address Line | 8619 RESEDA BLVD STE 101A
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City | NORTHRIDGE
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State | CA
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Zip | 91324-6148
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Country | US
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Telephone | 818-886-3742
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Fax | 818-886-3763
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Provider Business Mailing Address
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Address Line | 8619 RESEDA BLVD STE 101A
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City | NORTHRIDGE
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State | CA
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Zip | 91324-4044
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Country | US
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Telephone | 818-886-3742
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Fax | 818-886-3763
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Authorized Official
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Title or Position | OWNER AND PHARMACIST
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Name | AURORA ALCANTARA
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Credential |
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Telephone | 818-642-7765
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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 | PHY48195
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License Number State | CA
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