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General NPI Number Information
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NPI Number | 1881248375
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Entity Type | Individual
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Provider Name | SETA SETRAK PHARMACY TECH
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Gender | Female
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Dates
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Enumeration Date | 08/01/2019
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Last Update Date | 08/01/2019
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Provider Practice Location Address
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Address Line | 1400 W KENNETH RD
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City | GLENDALE
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State | CA
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Zip | 91201-1422
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Country | US
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Telephone | 818-242-4158
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Fax | 818-247-8593
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Provider Business Mailing Address
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Address Line | 1012 S ADAMS ST APT 4
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City | GLENDALE
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State | CA
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Zip | 91205-4407
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Country | US
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Telephone | 818-549-1358
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 66162
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License Number State | CA
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