MEDICARE: MR. BABIC GARY BABIKIAN RPH

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	RPH 31062	CA

General Provider Information

NPI Number	:	1235347543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BABIC GARY BABIKIAN RPH

Provider Business Mailing Address
First Line	:	5101 HOLLYWOOD BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-6105
Country	:	US
Telephone Number	:	323-668-0523
Fax Number	:	323-668-0524

Provider Business Practice Location Address
First Line	:	5101 HOLLYWOOD BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-6105
Country	:	US
Telephone Number	:	323-668-0523
Fax Number	:	323-668-0524

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

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	07/08/2007

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