Organization
SOCAL PHARMACY LLC
Active
Other names
Grove Harbor Medical Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SEID AMIR FARZAN TAVAKKOLI ISFAHANI PHARMD (PRESIDENT)
(256) 797-2552
Entity
Organization
Contact information
Practice address
12555 GARDEN GROVE BLVD STE 102, GARDEN GROVE, CA 92843-1903
(714) 636-0593
(714) 636-7708
Mailing address
12555 GARDEN GROVE BLVD STE 102, GARDEN GROVE, CA 92843-1903
(714) 636-0593
(714) 636-7708
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649713777
—
CA
Enumeration date
03/08/2020
Last updated
12/08/2023
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