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General NPI Number Information
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NPI Number | 1871959189
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Entity Type | Organization
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Legal Business Name | MZMZ CORP.
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Dates
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Enumeration Date | 01/04/2016
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Last Update Date | 01/15/2016
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Provider Practice Location Address
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Address Line | 17609 VENTURA BLVD STE LL06
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City | ENCINO
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State | CA
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Zip | 91316-5137
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Country | US
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Telephone | 818-464-4988
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Fax | 818-464-4989
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Provider Business Mailing Address
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Address Line | 17609 VENTURA BLVD LL06
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City | ENCINO
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State | CA
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Zip | 91316-3858
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Country | US
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Telephone | 818-464-4988
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Fax | 818-464-4989
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL LERNER
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Credential |
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Telephone | 424-268-6028
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 58321
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License Number State | CA
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