Healthcare Provider Details

I. General information

NPI: 1952904906
Provider Name (Legal Business Name): AMY CHIN LIEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2020
Last Update Date: 11/20/2020
Certification Date: 11/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17284 SLOVER AVE STE 204
FONTANA CA
92337-7584
US

IV. Provider business mailing address

9461 SEAN WAY
WESTMINSTER CA
92683-7437
US

V. Phone/Fax

Practice location:
  • Phone: 714-466-0928
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number82873
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: