Organization
1663 PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TEODORO REYES SANTOS (PHARMACIST)
(213) 250-7229
Entity
Organization
Contact information
Practice address
1663 BEVERLY BLVD, LOS ANGELES, CA 90026-5710
(213) 250-7229
(213) 250-0439
Mailing address
1663 BEVERLY BLVD, LOS ANGELES, CA 90026-5710
(213) 250-7229
(213) 250-0439
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
31852
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0573445
NABP
CA
01
—
1497865570
INDIVIDUAL NPI NUMBER
CA
05
—
PHY229000
—
CA
Enumeration date
12/18/2006
Last updated
08/22/2020
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