Healthcare Provider Details

I. General information

NPI: 1972680841
Provider Name (Legal Business Name): CANDO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 09/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1141 W REDONDO BEACH BLVD STE 100
GARDENA CA
90247-3586
US

IV. Provider business mailing address

1141 W REDONDO BEACH BLVD STE 100
GARDENA CA
90247-3586
US

V. Phone/Fax

Practice location:
  • Phone: 310-515-1881
  • Fax: 310-515-0951
Mailing address:
  • Phone: 310-515-1881
  • Fax: 310-515-0951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY37322
License Number StateCA

VIII. Authorized Official

Name: CANDACE SHAW
Title or Position: CLINICAL PHARMACIST,OWNER
Credential: PHARM.D.
Phone: 310-515-1881