Organization
PV DRUG STORE
Active
Other names
PV Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
VAHID BORDBAR PHARM.D (OWNER, PIC, AO)
(310) 462-1310
Entity
Organization
Contact information
Practice address
2325 PALOS VERDES DR W STE 220, PALOS VERDES ESTATES, CA 90274-2777
(424) 327-2990
(424) 327-2996
Mailing address
2325 PALOS VERDES DR W STE 220, PALOS VERDES ESTATES, CA 90274-2777
(424) 327-2990
(424) 327-2996
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY54543
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2162223
PK
—
Enumeration date
07/27/2016
Last updated
07/19/2018
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