MEDICARE: ADRINEH KESHISH

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	70182	CA

General Provider Information

NPI Number	:	1225451396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRINEH KESHISH

Provider Business Mailing Address
First Line	:	10515 BALBOA BLVD STE 125
Second Line	:
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-6354
Country	:	US
Telephone Number	:	747-600-5999
Fax Number	:

Provider Business Practice Location Address
First Line	:	428 HAWTHORNE ST APT 113
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-3107
Country	:	US
Telephone Number	:	818-808-5625
Fax Number	:

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

Provider Enumeration Date	:	01/27/2014
Last Update Date	:	10/13/2023

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