MEDICARE: PAUL LITSEY RPH

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	1835P2201X	Ambulatory Care Pharmacist	RPH27837	CA

General Provider Information

NPI Number	:	1982136354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL LITSEY RPH

Provider Business Mailing Address
First Line	:	1447 DEL MONTE DR
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91207-1205
Country	:	US
Telephone Number	:	818-823-8823
Fax Number	:

Provider Business Practice Location Address
First Line	:	1447 DEL MONTE DR
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91207-1205
Country	:	US
Telephone Number	:	818-823-8823
Fax Number	:

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

Provider Enumeration Date	:	04/03/2017
Last Update Date	:	04/03/2017

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