Individual
CARRIE OTANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4561 S CENTINELA AVE, LOS ANGELES, CA 90066-6248
(310) 822-6354
(310) 822-6540
Mailing address
4561 S CENTINELA AVE, LOS ANGELES, CA 90066-6248
(310) 822-6354
(310) 822-6540
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY56935
CA
Other
Enumeration date
11/07/2018
Last updated
11/07/2018
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