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General NPI Number Information
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NPI Number | 1871837344
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Entity Type | Organization
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Legal Business Name | VENICE FAMILY CLINIC
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Dates
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Enumeration Date | 11/21/2012
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 604 ROSE AVE
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City | VENICE
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State | CA
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Zip | 90291-2767
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Country | US
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Telephone | 310-664-7735
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Fax | 310-396-9360
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Provider Business Mailing Address
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Address Line | 604 ROSE AVE
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City | VENICE
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State | CA
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Zip | 90291-2767
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Country | US
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Telephone | 310-392-8636
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Fax | 310-664-7711
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Authorized Official
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Title or Position | CHIEF COMPLIANCE OFFICER
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Name | ISABELA MIHAI
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Credential |
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Telephone | 310-593-9594
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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 | 51023
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License Number State | CA
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