Basic Information
| Provider Information | |||||||||
| NPI: | 1912087537 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLASCHA | ||||||||
| FirstName: | STEPHAN | ||||||||
| MiddleName: | LEO | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | R.PH. -PHARM.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2100 S CANFIELD AVE | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900341113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102021074 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1130 WILSHIRE BLVD | ||||||||
| Address2: | US DEPT OF VETERANS AFFAIRS GLA HEALTHCARE SYSTEM | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104783711 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2006 | ||||||||
| LastUpdateDate: | 01/07/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 37472 | CA | N | Pharmacy Service Providers | Pharmacist | 1835P0018X | 37472 | CA | N | Pharmacy Service Providers | Pharmacist | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P1200X | 37472 | CA | Y | Pharmacy Service Providers | Pharmacist | Pharmacotherapy |
No ID Information.