Organization
CRENSHAW PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARDALAN BEHEL RPH (CEO)
(310) 402-7318
Entity
Organization
Contact information
Practice address
3631 CRENSHAW BLVD, STE 111, LOS ANGELES, CA 90016-4869
(323) 732-5555
(323) 734-5555
Mailing address
3631 CRENSHAW BLVD STE 111, LOS ANGELES, CA 90016-4869
(323) 732-5555
(323) 734-5555
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
54248
CA
3336C0003X
Community/Retail Pharmacy
Primary
PHY55990
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417346305
—
CA
Enumeration date
01/14/2015
Last updated
03/30/2022
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