Organization
PCCC INC
Active
Other names
Professional Compounding Center of California
Organization subpart
No
Provider details
NPI number
Authorized official
CYRUS RABIZADEH (MANAGER)
(818) 346-7222
Entity
Organization
Contact information
Practice address
23101 SHERMAN PL, 207, WEST HILLS, CA 91307-2003
(818) 346-7222
(818) 347-7222
Mailing address
23101 SHERMAN PL, 207, WEST HILLS, CA 91307-2003
(818) 346-7222
(818) 347-7222
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
49817
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5633830
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/30/2009
Last updated
06/25/2009
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