Provider Demographics
NPI:1124012505
Name:ESAGOFF, ASHER ERIC (DOCTOR OF PHARMACY)
Entity Type:Individual
Prefix:DR
First Name:ASHER
Middle Name:ERIC
Last Name:ESAGOFF
Suffix:
Gender:M
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 S LA CIENEGA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3339
Mailing Address - Country:US
Mailing Address - Phone:310-652-0550
Mailing Address - Fax:310-652-7882
Practice Address - Street 1:240 S LA CIENEGA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3339
Practice Address - Country:US
Practice Address - Phone:310-652-0550
Practice Address - Fax:310-652-7882
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY31130183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA31130Medicaid
CA0605870001Medicare ID - Type Unspecified
CAPHA31130Medicaid