Provider Demographics
NPI:1083628713
Name:SELEH, ELIAHOU (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ELIAHOU
Middle Name:
Last Name:SELEH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 S HOLT AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-2041
Mailing Address - Country:US
Mailing Address - Phone:310-854-0126
Mailing Address - Fax:
Practice Address - Street 1:910 S HOLT AVE APT 202
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-2041
Practice Address - Country:US
Practice Address - Phone:310-854-0126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH559371835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy