MEDICARE: DR. ANASTASIA LYNN GEORGE PHARM D, AAHIVP

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	62299	CA
2	183500000X	Pharmacist	058608	NY

General Provider Information

NPI Number	:	1851997225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANASTASIA LYNN GEORGE PHARM D, AAHIVP

Provider Business Mailing Address
First Line	:	4858 W PICO BLVD # 187
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-4225
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6240 WILSHIRE BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5104
Country	:	US
Telephone Number	:	800-806-0020
Fax Number	:

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

Provider Enumeration Date	:	12/09/2020
Last Update Date	:	12/09/2020

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