| NPI | 1639687585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY PHAM Owner/Pharmacy Manager 951-817-1005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CA 55935) |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2021-10-29 |