Provider Demographics
NPI:1669421640
Name:APOTEK GLOBAL
Entity type:Organization
Organization Name:APOTEK GLOBAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LALEH
Authorized Official - Middle Name:
Authorized Official - Last Name:TAHERI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:949-644-7575
Mailing Address - Street 1:2865 E COAST HWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-2236
Mailing Address - Country:US
Mailing Address - Phone:949-644-7575
Mailing Address - Fax:949-644-2340
Practice Address - Street 1:2865 E COAST HWY
Practice Address - Street 2:SUITE 150
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625-2236
Practice Address - Country:US
Practice Address - Phone:949-644-7575
Practice Address - Fax:949-644-2340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY536353336C0004X, 3336C0003X
CAPHY460073336H0001X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding PharmacyGroup - Single Specialty
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0513499OtherNABP NUMBER
CA0513499OtherNABP NUMBER
CA0944990001Medicare NSC