| NPI | 1134786437 |
|---|---|
| Doing Business As | 986 PHARMACY #8025 |
| Entity Type | Organization |
| Authorized Contact | JOHN GONG CEO 310-780-7470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2024-08-14 |