| NPI | 1891245619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH LOUIS GURNICK Owner 310-553-7691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: CA E2615A) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2016-10-04 |