| NPI | 1235643628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILAH NGO Credentialing Coordinator 714-898-8888 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY54496) |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2017-11-22 |