Organization
WESTLAKE MEDICAL MANAGEMENT INC.
Active
Other names
Westlake Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANA BLUMKIN (PRESIDENT)
(213) 383-4262
Entity
Organization
Contact information
Practice address
529 S ALVARADO ST, LOS ANGELES, CA 90057-2903
(213) 383-4262
(213) 383-4263
Mailing address
529 S ALVARADO ST, LOS ANGELES, CA 90057-2903
(213) 383-4262
(213) 383-4263
Taxonomy
Speciality
Code
Description
License number
State
332BN1400X
Nursing Facility Supplies (DME)
3892040001
CA
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY55804
CA STATE BOARD OF PHARMACY
CA
Enumeration date
06/24/2006
Last updated
10/02/2019
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