Organization
IRDGAS
Active
Other names
serra medical pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD DENNIS MANZANI PHARM. D. (PRESIDENT)
(818) 768-3322
Entity
Organization
Contact information
Practice address
9375 SAN FERNANDO RD, SUN VALLEY, CA 91352-1418
(818) 768-3322
(818) 504-0418
Mailing address
9375 SAN FERNANDO RD, SUN VALLEY, CA 91352-1418
(818) 768-3322
(818) 504-0418
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
PHY406210
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA406210
—
CA
Enumeration date
01/04/2008
Last updated
01/04/2008
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