Organization
PLAZA PHARMACY INC
Active
Other names
PLAZA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TOORAJ BERELIANI (OWNER)
(310) 497-9251
Entity
Organization
Contact information
Practice address
16952 VENTURA BLVD, STE 100, ENCINO, CA 91316-4197
(818) 380-0102
(818) 380-0164
Mailing address
13351 RIVERSIDE DR STE D, SUITE 353, SHERMAN OAKS, CA 91423-2542
(818) 380-0102
(818) 380-0164
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY49090
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5630480
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/21/2008
Last updated
01/19/2010
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