| NPI | 1821137118 |
|---|---|
| Doing Business As | 111 PHARMACY |
| Entity Type | Organization |
| Authorized Contact | BOONAM SHIN Owner 323-742-8111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY41023) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2011-05-27 |