| NPI | 1174502447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD LAXER PIC 310-486-3794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: CA PHY42139) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2025-09-11 |