| NPI | 1144304304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS J LIAUTAUD President 213-413-2343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 120429) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: CA PHY12414) |
| 3336C0004X Pharmacy Compounding Pharmacy (Licence: CA PHY12414) | |
| 3336S0011X Pharmacy Specialty Pharmacy (Licence: CA PHY12414) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |