| NPI | 1124719075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY KHUONG TRAN Officer 657-227-3686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2023-05-19 |
| Last Update Date | 2024-12-21 |