# SOCAL PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Grove Harbor Medical Center Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033744230
- **Authorized official:** SEID AMIR FARZAN TAVAKKOLI ISFAHANI PHARMD (PRESIDENT)
- **Authorized official phone:** (256) 797-2552

## Contact information

- **Practice address:** 12555 GARDEN GROVE BLVD STE 102, GARDEN GROVE, CA 92843-1903
- **Practice address phone:** (714) 636-0593
- **Practice address fax:** (714) 636-7708
- **Mailing address:** 12555 GARDEN GROVE BLVD STE 102, GARDEN GROVE, CA 92843-1903
- **Mailing address phone:** (714) 636-0593
- **Mailing address fax:** (714) 636-7708

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 03/08/2020
- **Last updated:** 12/08/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1649713777 | — | CA |