| NPI | 1083744916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY GROSS President 310-271-6123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CA PHY51055) |
| Additional Taxonomies | 163WD0400X Registered Nurse Diabetes Educator |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2019-01-07 |