Healthcare Provider Details

I. General information

NPI: 1689848269
Provider Name (Legal Business Name): VERDUGO PLAZA PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 09/19/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3039 W VALLEY BLVD
ALHAMBRA CA
91803-1822
US

IV. Provider business mailing address

3039 W VALLEY BLVD
ALHAMBRA CA
91803-1822
US

V. Phone/Fax

Practice location:
  • Phone: 626-281-3799
  • Fax: 626-281-0711
Mailing address:
  • Phone: 626-281-3799
  • Fax: 626-281-0711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHY49003
License Number StateCA

VIII. Authorized Official

Name: LAWRENCE WONG
Title or Position: PRESIDENT
Credential:
Phone: 626-281-3799