| NPI | 1356525760 |
|---|---|
| Doing Business As | KOMOTO CUSTOM CARE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | PATRICK NELSON LEROY Pharmacist In Charge 661-716-2673 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: CA PHY46042) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY46042) |
| 3336S0011X Pharmacy, Specialty Pharmacy (Licence: CA LSC99071) | |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2012-11-26 |