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NPI Code Detail

MEDICARE: DAHLIA BOCTOR PHARMD

MEDICARE:   DAHLIA  BOCTOR  PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist53006CA

General Provider Information

NPI Number : 1043592595
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAHLIA BOCTOR PHARMD
Provider Business Mailing Address
First Line : 639 ARDEN AVE
Second Line :
City : GLENDALE
State : CA
Zip : 91202-2856
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3000 S BRISTOL ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92704-6707
Country : US
Telephone Number : 714-427-3986
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2011
Last Update Date : 09/11/2011

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Directions to “ DAHLIA BOCTOR PHARMD” Practice Location

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