Healthcare Provider Details

I. General information

NPI: 1932203981
Provider Name (Legal Business Name): HOWARD A LIPTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 06/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 N PLACENTIA AVE
FULLERTON CA
92831-3290
US

IV. Provider business mailing address

731 N PLACENTIA AVE
FULLERTON CA
92831-3290
US

V. Phone/Fax

Practice location:
  • Phone: 714-996-4642
  • Fax: 714-996-4643
Mailing address:
  • Phone: 714-996-4642
  • Fax: 714-996-4643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY33998
License Number StateCA

VIII. Authorized Official

Name: HOWARD LIPTON
Title or Position: OWNER/PHARMACIST
Credential:
Phone: 714-996-4642