Individual
MR. FARIBORZ DAVID MASSOUDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
891 W 9TH ST, SAN PEDRO, CA 90731-3603
(310) 833-2575
(310) 832-2531
Mailing address
891 W 9TH ST, SAN PEDRO, CA 90731-3603
(310) 833-2575
(310) 832-2531
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY45471
CA
3336L0003X
Long Term Care Pharmacy
PHY45471
CA
Other
Enumeration date
02/05/2007
Last updated
08/08/2016
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