Organization
ATAZAK INC
Active
Other names
Kovacs-Frey Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
AHMED ATALLAH (PRESIDENT)
(310) 951-4456
Entity
Organization
Contact information
Practice address
2860 ARTESIA BLVD, REDONDO BEACH, CA 90278-3421
(310) 371-7541
(310) 542-1488
Mailing address
2860 ARTESIA BLVD, REDONDO BEACH, CA 90278-3421
(310) 371-7541
(310) 542-1488
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY53371
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2154379
PK
—
Enumeration date
11/08/2006
Last updated
08/10/2016
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