Provider Demographics
NPI:1710330998
Name:KOKABI PHARMACEUTICAL, INC.
Entity Type:Organization
Organization Name:KOKABI PHARMACEUTICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAVEH
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:KOKABI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:818-261-2320
Mailing Address - Street 1:20144 WELLS DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-4728
Mailing Address - Country:US
Mailing Address - Phone:818-261-2320
Mailing Address - Fax:
Practice Address - Street 1:201 CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-6831
Practice Address - Country:US
Practice Address - Phone:818-261-2320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH62158183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty