Provider Demographics
NPI:1154310803
Name:YOUNESI, FARGOL LIMOR (PHARMD)
Entity Type:Individual
Prefix:
First Name:FARGOL
Middle Name:LIMOR
Last Name:YOUNESI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 MALCOLM AVE
Mailing Address - Street 2:301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-7821
Mailing Address - Country:US
Mailing Address - Phone:310-475-3424
Mailing Address - Fax:213-612-4300
Practice Address - Street 1:444 S FLOWER ST
Practice Address - Street 2:100
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90071-2901
Practice Address - Country:US
Practice Address - Phone:213-612-4300
Practice Address - Fax:213-612-4313
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54799183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist