MEDICARE: SUNSET CENTER PHARMACY,INC

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	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982754727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSET CENTER PHARMACY,INC

Provider Business Mailing Address
First Line	:	5137 1/2 W SUNSET BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-5715
Country	:	US
Telephone Number	:	323-664-1882
Fax Number	:	323-664-1809

Provider Business Practice Location Address
First Line	:	5137 W SUNSET BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-5715
Country	:	US
Telephone Number	:	323-664-1882
Fax Number	:	323-664-1809

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MARDIROS BASTEGUIAN
Credential	:
Telephone Number	:	323-664-1882

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	08/22/2020

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