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NPI Code Detail

MEDICARE: DR. LARRY ERESHEFSKY PHARM.D.

MEDICARE: DR. LARRY ERESHEFSKY 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
11835P1300XPsychiatric Pharmacist30285CA

General Provider Information

NPI Number : 1952308090
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LARRY ERESHEFSKY PHARM.D.
Provider Business Mailing Address
First Line : 2671 ASTRAL DR
Second Line :
City : LOS ANGELES
State : CA
Zip : 90046-1707
Country : US
Telephone Number : 310-415-8131
Fax Number : 323-512-7197
Provider Business Practice Location Address
First Line : 1509 WILSON TER
Second Line : WING 55 MAIN FLOOR
City : GLENDALE
State : CA
Zip : 91206-4007
Country : US
Telephone Number : 818-254-1658
Fax Number : 818-545-8048
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2005
Last Update Date : 07/08/2007

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