Provider Demographics
NPI:1194822932
Name:MYBIZ26 INC
Entity Type:Organization
Organization Name:MYBIZ26 INC
Other - Org Name:PALI-RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PIC
Authorized Official - Prefix:MRS
Authorized Official - First Name:YASAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHABBOUEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-454-0377
Mailing Address - Street 1:900 VIA DE LA PAZ
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-3549
Mailing Address - Country:US
Mailing Address - Phone:310-454-0377
Mailing Address - Fax:310-454-0378
Practice Address - Street 1:900 VIA DE LA PAZ
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-3549
Practice Address - Country:US
Practice Address - Phone:310-454-0377
Practice Address - Fax:310-454-0378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY 50709333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0505771OtherOTHER ID NUMBER-COMMERCIAL NUMBER
CAPHY 50709OtherCALIFORNIA STATE BOARD OF PHARMACY RETAIL PERMIT