| NPI | 1700895034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN QUON Manager 510-548-0773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CA PHY22894) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2007-08-31 |