MEDICARE: JESSICA SADIK

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	73612	CA

General Provider Information

NPI Number	:	1710350038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA SADIK

Provider Business Mailing Address
First Line	:	4030 S WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90062-1634
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4030 S WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90062-1634
Country	:	US
Telephone Number	:	323-292-7009
Fax Number	:

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

Provider Enumeration Date	:	11/09/2015
Last Update Date	:	11/09/2015

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Directions to “ JESSICA SADIK ” Practice Location

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