Organization
CALIFORNIA STATE UNIVERSITY, NORTHRIDGE
Active
Other names
Klotz Student Health Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YOLANDA REID CHASSIAKOS M.D. (DIRECTOR, STUDENT HEALTH CENTER)
(818) 677-3666
Entity
Organization
Contact information
Practice address
18111 NORDHOFF ST, NORTHRIDGE, CA 91330-8270
(818) 677-3666
(818) 677-7732
Mailing address
18111 NORDHOFF ST, NORTHRIDGE, CA 91330-8270
(818) 677-3671
(818) 677-7732
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHE19585
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHE195850
—
CA
Enumeration date
02/02/2007
Last updated
09/17/2014
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