Organization
SHERMAN CARE ENTERPRISE,INC
Active
Other names
MESA CARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BABAK KOHANTEB (PRESIDENT/CEO)
(818) 785-6049
Entity
Organization
Contact information
Practice address
7218 VAN NUYS BLVD STE B, VAN NUYS, CA 91405-6803
(818) 618-1200
(818) 785-5907
Mailing address
7218 VAN NUYS BLVD STE B, VAN NUYS, CA 91405-6803
(818) 618-1200
(818) 785-5907
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY57998
CALIFORNIA STATE BOARD OF PHARMACY
CA
Enumeration date
12/08/2020
Last updated
12/08/2020
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