MEDICARE: TEMPLE CITY PROFESSIONAL PHARMACY INC.

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	PHY 30427	CA

General Provider Information

NPI Number	:	1992871784
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEMPLE CITY PROFESSIONAL PHARMACY INC.

Provider Business Mailing Address
First Line	:	9678 LAS TUNAS DR
Second Line	:
City	:	TEMPLE CITY
State	:	CA
Zip	:	91780-2139
Country	:	US
Telephone Number	:	626-286-9762
Fax Number	:	626-286-7476

Provider Business Practice Location Address
First Line	:	9678 LAS TUNAS DR
Second Line	:
City	:	TEMPLE CITY
State	:	CA
Zip	:	91780-2139
Country	:	US
Telephone Number	:	626-286-9762
Fax Number	:	626-286-7476

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. AKBAR YAHYA KHORAKIWALA
Credential	:	RPH
Telephone Number	:	626-286-9762

Provider Enumeration Date	:	11/26/2006
Last Update Date	:	08/22/2020

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