Provider Demographics
NPI:1588657290
Name:KANJI ENTERPRISES INC
Entity Type:Organization
Organization Name:KANJI ENTERPRISES INC
Other - Org Name:MED-CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NAUSHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:KANJI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:818-785-4944
Mailing Address - Street 1:14624 SHERMAN WAY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-2241
Mailing Address - Country:US
Mailing Address - Phone:818-785-4944
Mailing Address - Fax:818-785-3918
Practice Address - Street 1:14624 SHERMAN WAY
Practice Address - Street 2:SUITE 104
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2241
Practice Address - Country:US
Practice Address - Phone:818-785-4944
Practice Address - Fax:818-785-3918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY43733333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA437330Medicaid