Provider Demographics
NPI:1003173121
Name:KASTER, BENJAMIN S (RPH)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:S
Last Name:KASTER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11340 IOWA AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4293
Mailing Address - Country:US
Mailing Address - Phone:310-478-6179
Mailing Address - Fax:310-478-6179
Practice Address - Street 1:11340 IOWA AVE APT 8
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4293
Practice Address - Country:US
Practice Address - Phone:310-478-6179
Practice Address - Fax:310-478-6179
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37801183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist