Provider Demographics
NPI:1093875791
Name:REITZENSTEIN, IRVING (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:IRVING
Middle Name:
Last Name:REITZENSTEIN
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 1:16928 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-4124
Mailing Address - Country:US
Mailing Address - Phone:818-788-0635
Mailing Address - Fax:818-386-2688
Practice Address - Street 1:16928 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-4124
Practice Address - Country:US
Practice Address - Phone:818-788-0635
Practice Address - Fax:818-386-2688
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist