Healthcare Provider Details

I. General information

NPI: 1649713777
Provider Name (Legal Business Name): SOCAL PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2016
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12555 GARDEN GROVE BLVD SUITE 102
GARDEN GROVE CA
92843-1902
US

IV. Provider business mailing address

PO BOX 3055
HUNTINGTON BEACH CA
92605-3055
US

V. Phone/Fax

Practice location:
  • Phone: 256-714-0593
  • Fax: 714-636-7708
Mailing address:
  • Phone: 714-706-9030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. MICHAEL ZEGLINSKI
Title or Position: CEO
Credential:
Phone: 714-706-9030