Provider Demographics
NPI:1194577379
Name:LOS ANGELES PHARMACY LLC
Entity type:Organization
Organization Name:LOS ANGELES PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:LALEHZARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-421-9085
Mailing Address - Street 1:2405 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-2218
Mailing Address - Country:US
Mailing Address - Phone:323-352-8512
Mailing Address - Fax:323-325-5949
Practice Address - Street 1:2405 N BROADWAY
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90031-2218
Practice Address - Country:US
Practice Address - Phone:323-352-8512
Practice Address - Fax:323-325-5949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy