MEDICARE: KWABENA ASABERE DPHARM

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	1835P2201X	Ambulatory Care Pharmacist	54328	CA

General Provider Information

NPI Number	:	1285080788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KWABENA ASABERE DPHARM

Provider Business Mailing Address
First Line	:	4501 W SLAUSON AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90043-2719
Country	:	US
Telephone Number	:	323-292-4114
Fax Number	:	323-292-4478

Provider Business Practice Location Address
First Line	:	4501 W SLAUSON AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90043-2719
Country	:	US
Telephone Number	:	323-292-4114
Fax Number	:	323-292-4478

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

Provider Enumeration Date	:	05/13/2016
Last Update Date	:	05/13/2016

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