# IRVINE MEDICAL PHARMACY INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** IRVINE MEDICAL PHARMACY INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326125295
- **Authorized official:** NASSER FATHI PHRM (PIC)
- **Authorized official phone:** (949) 552-7777

## Contact information

- **Practice address:** 14130 CULVER DR, STE D, IRVINE, CA 92604-0314
- **Practice address phone:** (949) 552-7777
- **Practice address fax:** (949) 552-7292
- **Mailing address:** 14130 CULVER DR, STE D, IRVINE, CA 92604-0314
- **Mailing address phone:** (949) 552-7777
- **Mailing address fax:** (949) 552-7292

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | PHY42046 | CA | Yes |

## Other

- **Enumeration date:** 10/31/2006
- **Last updated:** 03/14/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0568634 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |
| 05 | — | PHA420460 | — | CA |