MEDICARE: UNITED MEDCARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336L0003X	Long Term Care Pharmacy	55401	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2176314	OTHER		PK

General Provider Information

NPI Number	:	1184127805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED MEDCARE

Provider Business Mailing Address
First Line	:	1127 WILSHIRE BLVD STE 201
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-3903
Country	:	US
Telephone Number	:	213-482-0644
Fax Number	:	213-482-0668

Provider Business Practice Location Address
First Line	:	1127 WILSHIRE BLVD STE 201
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-3903
Country	:	US
Telephone Number	:	213-482-0644
Fax Number	:	213-482-0668

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FUNG-WAH LAM
Credential	:
Telephone Number	:	213-482-0644

Provider Enumeration Date	:	03/09/2018
Last Update Date	:	06/22/2021

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Directions to “UNITED MEDCARE ” Practice Location

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