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Organization
IRVINE MEDICAL PHARMACY INC
Active
Organization
IRVINE MEDICAL PHARMACY INC
Active
Other names
IRVINE MEDICAL PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
NASSER FATHI PHRM (PIC)
(949) 552-7777
Entity
Organization
Contact information
Practice address
14130 CULVER DR, STE D, IRVINE, CA 92604-0314
(949) 552-7777
(949) 552-7292
Mailing address
14130 CULVER DR, STE D, IRVINE, CA 92604-0314
(949) 552-7777
(949) 552-7292
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
PHY42046
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0568634
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA420460
—
CA
Enumeration date
10/31/2006
Last updated
03/14/2013
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