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NPI Code Detail

MEDICARE: DR. NASSIM TINA ALTOMEH PHARM.D

MEDICARE: DR. NASSIM TINA ALTOMEH PHARM.D
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
1183500000XPharmacist65805CA

General Provider Information

NPI Number : 1487197323
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NASSIM TINA ALTOMEH PHARM.D
Provider Business Mailing Address
First Line : 2505 SANTA MONICA BLVD
Second Line :
City : SANTA MONICA
State : CA
Zip : 90404-2011
Country : US
Telephone Number : 818-825-9493
Fax Number : 310-829-4375
Provider Business Practice Location Address
First Line : 2505 SANTA MONICA BLVD
Second Line :
City : SANTA MONICA
State : CA
Zip : 90404-2011
Country : US
Telephone Number : 818-825-9493
Fax Number : 310-829-4375
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2016
Last Update Date : 11/27/2016

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