Provider Demographics
NPI:1306964416
Name:PILLER, OLEG (PHARMACY TECH)
Entity type:Individual
Prefix:MR
First Name:OLEG
Middle Name:
Last Name:PILLER
Suffix:
Gender:M
Credentials:PHARMACY TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4930 BALBOA BLVD
Mailing Address - Street 2:261996
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91426-7001
Mailing Address - Country:US
Mailing Address - Phone:818-261-5010
Mailing Address - Fax:888-421-5959
Practice Address - Street 1:4930 BALBOA BLVD
Practice Address - Street 2:261996
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91426-7001
Practice Address - Country:US
Practice Address - Phone:818-261-5010
Practice Address - Fax:888-421-5959
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2118183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician