MEDICARE: BRENDA L NEAL

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	51485	CA

General Provider Information

NPI Number	:	1245508399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA L NEAL

Provider Business Mailing Address
First Line	:	2322 W 78TH ST
Second Line	:
City	:	INGLEWOOD
State	:	CA
Zip	:	90305-1118
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3331 W CENTURY BLVD
Second Line	:
City	:	INGLEWOOD
State	:	CA
Zip	:	90303-1366
Country	:	US
Telephone Number	:	310-671-1523
Fax Number	:	310-671-2179

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

Provider Enumeration Date	:	12/05/2011
Last Update Date	:	12/05/2011

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Directions to “ BRENDA L NEAL ” Practice Location

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