Organization
BLAST PHARMA INC
Active
Other names
BLAST PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED HUSSEIN (CEO)
(714) 733-7978
Entity
Organization
Contact information
Practice address
1721 W KATELLA AVE STE J, ANAHEIM, CA 92804-8100
(714) 733-7879
(714) 733-7969
Mailing address
1721 W KATELLA AVE STE J, ANAHEIM, CA 92804-8100
(714) 733-7879
(714) 733-7969
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Enumeration date
08/26/2021
Last updated
06/06/2024
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