Provider Demographics
NPI:1740322981
Name:MARTEN, VILAI (PHARM D)
Entity type:Individual
Prefix:DR
First Name:VILAI
Middle Name:
Last Name:MARTEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8930 S SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3606
Mailing Address - Country:US
Mailing Address - Phone:310-670-3463
Mailing Address - Fax:310-670-4038
Practice Address - Street 1:8930 S SEPULVEDA BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3606
Practice Address - Country:US
Practice Address - Phone:310-670-3463
Practice Address - Fax:310-670-4038
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28514183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist