MEDICARE: BEVERLY HIRK

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	88938	CA

General Provider Information

NPI Number	:	1366203135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEVERLY HIRK

Provider Business Mailing Address
First Line	:	2080 S MANGRUM CT
Second Line	:
City	:	LA HABRA
State	:	CA
Zip	:	90631-2076
Country	:	US
Telephone Number	:	562-852-9789
Fax Number	:

Provider Business Practice Location Address
First Line	:	3644 E OLYMPIC BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90023-3129
Country	:	US
Telephone Number	:	323-264-0496
Fax Number	:

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

Provider Enumeration Date	:	01/18/2024
Last Update Date	:	01/18/2024

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Directions to “ BEVERLY HIRK ” Practice Location

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