| NPI | 1386160919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE KIM Secretary/PIC 909-591-7429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CA 55791) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2022-07-21 |