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NPI Code Detail

MEDICARE: REBECCA LYNN FLUECK PHARM.D.

MEDICARE:   REBECCA LYNN FLUECK  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
1183500000XPharmacist61086CA

General Provider Information

NPI Number : 1881978401
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA LYNN FLUECK PHARM.D.
Provider Business Mailing Address
First Line : 11795 W OLYMPIC BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1211
Country : US
Telephone Number : 310-312-6506
Fax Number : 310-473-0195
Provider Business Practice Location Address
First Line : 11795 W OLYMPIC BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1211
Country : US
Telephone Number : 310-312-6506
Fax Number : 310-473-0195
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2011
Last Update Date : 09/30/2011

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Directions to “ REBECCA LYNN FLUECK PHARM.D.” Practice Location

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