Registry details
Type
Individual
Primary specialty
Pharmacist
Enumerated
Jan 18, 2023
License(s)
46894 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1311 CORDOVA AVE | Glendale, CA 91207-1529 | 818-427-0717 |
| LOCATION | 1400 S GRAND AVE STE 801 | Los Angeles, CA 90015-3068 | 213-741-5271 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.