Healthcare Provider Details

I. General information

NPI: 1447253448
Provider Name (Legal Business Name): WILSHIRE PHARMCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4420 E MIRALOMA AVE STE F
ANAHEIM CA
92807-1838
US

IV. Provider business mailing address

26611 CABOT RD. STE B
LAGUNA HILLS CA
92653-7018
US

V. Phone/Fax

Practice location:
  • Phone: 714-701-1192
  • Fax: 714-701-1195
Mailing address:
  • Phone: 949-348-7900
  • Fax: 714-701-1195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SAMEL K LEE
Title or Position: PRESIDENT/CEO
Credential: PHARMD
Phone: 949-348-7900