MEDICARE: SUN DRUG PHARMA 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
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PHY59330	OTHER	CA	BOARD OF PHARMACY

General Provider Information

NPI Number	:	1407941107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUN DRUG PHARMA INC

Provider Business Mailing Address
First Line	:	3200 LOS FELIZ BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90039-1509
Country	:	US
Telephone Number	:	323-663-8017
Fax Number	:	323-663-0770

Provider Business Practice Location Address
First Line	:	3200 LOS FELIZ BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90039-1509
Country	:	US
Telephone Number	:	323-663-8017
Fax Number	:	323-663-0770

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	ANI GHAPLANYAN
Credential	:
Telephone Number	:	323-663-8017

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	04/19/2024

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Directions to “SUN DRUG PHARMA INC ” Practice Location

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