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NPI Code Detail

MEDICARE: ORGLIFE INC

MEDICARE: ORGLIFE INC
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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PHY61452OTHERCABOP

General Provider Information

NPI Number : 1306211420
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORGLIFE INC
Provider Business Mailing Address
First Line : 12038 VENTURA BLVD STE A
Second Line :
City : STUDIO CITY
State : CA
Zip : 91604-2608
Country : US
Telephone Number : 818-508-0800
Fax Number : 818-500-0012
Provider Business Practice Location Address
First Line : 12038 VENTURA BLVD STE A
Second Line :
City : STUDIO CITY
State : CA
Zip : 91604-2608
Country : US
Telephone Number : 818-508-0800
Fax Number : 818-500-0012
Authorized Official
Title or Position : PRESIDENT/CEO
Name : JACOB ELYAKAMAL
Credential : PHARM D
Telephone Number : 818-508-0800
Provider Enumeration Date : 12/01/2015
Last Update Date : 03/17/2026

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Directions to “ORGLIFE INC ” Practice Location

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