Provider Demographics
NPI:1154082964
Name:LOS ANGELES PHARMACY LLC
Entity Type:Organization
Organization Name:LOS ANGELES PHARMACY LLC
Other - Org Name:LOS ANGELES PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:LALEHZARI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMDD
Authorized Official - Phone:310-497-2086
Mailing Address - Street 1:1431 S BEDFORD ST APT 5
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-3563
Mailing Address - Country:US
Mailing Address - Phone:310-497-2086
Mailing Address - Fax:
Practice Address - Street 1:8628 W PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-2302
Practice Address - Country:US
Practice Address - Phone:310-497-2086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-04
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY58050OtherBOARD OF PHARMACY