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Organization
TURAJ TOM SHAFA
Active
Organization
TURAJ TOM SHAFA
Active
Other names
MID WEST MEDICAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TOM SHAFA RPH (OWNER, PIC, AO)
(310) 657-1635
Entity
Organization
Contact information
Practice address
8733 BEVERLY BLVD, STE 100, WEST HOLLYWOOD, CA 90048-1890
(310) 657-1635
(310) 657-5455
Mailing address
8733 BEVERLY BLVD, STE 100, WEST HOLLYWOOD, CA 90048-1890
(310) 657-1635
(310) 657-5455
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY22051
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2002290
PK
—
05
—
PHA220510
—
CA
Enumeration date
12/04/2005
Last updated
12/22/2021
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