Provider Demographics
NPI:1073807830
Name:LOLOEE, SHADI (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:SHADI
Middle Name:
Last Name:LOLOEE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 SEPULVEDA BLVD STE 2250
Mailing Address - Street 2:T-2632
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6478
Mailing Address - Country:US
Mailing Address - Phone:310-754-4615
Mailing Address - Fax:310-754-4624
Practice Address - Street 1:6000 SEPULVEDA BLVD STE 2250
Practice Address - Street 2:T-2632
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6478
Practice Address - Country:US
Practice Address - Phone:310-754-4615
Practice Address - Fax:310-754-4624
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57441183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist