Organization
COLFAX PHARMACEUTICAL INC
Active
Other names
Brentwood Plaza Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BEN TEHRANI PHARM. D (CEO/PIC)
(310) 820-1496
Entity
Organization
Contact information
Practice address
11980 SAN VICENTE BLVD, STE 104, LOS ANGELES, CA 90049-5012
(310) 820-1496
(310) 820-4186
Mailing address
11980 SAN VICENTE BLVD, STE 104, LOS ANGELES, CA 90049-5012
(310) 820-1496
(310) 820-4186
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
51494
CA
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336247360
—
CA
01
—
2141894
PK
—
Enumeration date
09/21/2006
Last updated
06/13/2025
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