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General NPI Number Information
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NPI Number | 1962925057
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Entity Type | Individual
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Provider Name | IMAN IBRAHIM TOSSOUN RPH
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Gender | Female
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Dates
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Enumeration Date | 07/20/2017
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Last Update Date | 07/20/2017
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Provider Practice Location Address
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Address Line | 5309 RAMSDELL AVE
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City | LA CRESCENTA
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State | CA
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Zip | 91214-1924
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Country | US
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Telephone | 818-957-3488
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Fax | 818-957-3488
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Provider Business Mailing Address
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Address Line | 20839 WEST ROSCOE BLV CVS/CAREMARK
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City | WINNETKA
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State | CA
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Zip | 91306
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Country | US
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Telephone | 818-701-8911
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 51298
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 51298
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License Number State | CA
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