MEDICARE: SOCAL PHARMACY LLC

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	3336L0003X	Long Term Care Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PHY59248	OTHER	CA	BOP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447183975
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOCAL PHARMACY LLC

Provider Business Mailing Address
First Line	:	PO BOX 3055
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92605-3055
Country	:	US
Telephone Number	:	714-706-9030
Fax Number	:

Provider Business Practice Location Address
First Line	:	12555 GARDEN GROVE BLVD STE 102
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-1903
Country	:	US
Telephone Number	:	714-636-0593
Fax Number	:	714-636-7708

Authorized Official
Title or Position	:	CEO
Name	:	MICHAEL GERARD ZEGLINSKI
Credential	:
Telephone Number	:	714-706-9030

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “SOCAL PHARMACY LLC ” Practice Location

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