Organization
FAIR OAKS PLAZA PHARMACY CORP
Active
Other names
FAIR OAKS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ZAHRA SHAHNIANI (OWNER)
(626) 799-1414
Entity
Organization
Contact information
Practice address
1526 MISSION ST, S PASADENA, CA 91030-3216
(626) 799-1414
(626) 799-7609
Mailing address
1526 MISSION ST, S PASADENA, CA 91030-3216
(626) 799-1414
(626) 799-7609
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY47187
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2114964
PK
—
05
—
PHA471870
—
CA
Enumeration date
08/31/2006
Last updated
11/27/2013
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