Provider Demographics
NPI:1912087537
Name:FLASCHA, STEPHAN LEO (RPH -PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEPHAN
Middle Name:LEO
Last Name:FLASCHA
Suffix:
Gender:M
Credentials:RPH -PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 S CANFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-1113
Mailing Address - Country:US
Mailing Address - Phone:310-202-1074
Mailing Address - Fax:
Practice Address - Street 1:1130 WILSHIRE BLVD
Practice Address - Street 2:US DEPT OF VETERANS AFFAIRS GLA HEALTHCARE SYSTEM
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90073
Practice Address - Country:US
Practice Address - Phone:310-478-3711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37472183500000X, 1835P0018X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist