MEDICARE: GHANDI HALIM

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
1	183500000X	Pharmacist	37009	CA

General Provider Information

NPI Number	:	1144771064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GHANDI HALIM

Provider Business Mailing Address
First Line	:	3717 E SOUTH ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-4521
Country	:	US
Telephone Number	:	562-616-0056
Fax Number	:

Provider Business Practice Location Address
First Line	:	3717 E SOUTH ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-4521
Country	:	US
Telephone Number	:	562-616-0056
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2016
Last Update Date	:	10/14/2016

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Directions to “ GHANDI HALIM ” Practice Location

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