| NPI | 1043624489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL A. CAPEN President 323-556-3615 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: CA G32316) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2014-06-13 |