Healthcare Provider Details

I. General information

NPI: 1720902620
Provider Name (Legal Business Name): PACIFIC COAST RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7024 SEVILLE AVE STE E
HUNTINGTON PARK CA
90255-4969
US

IV. Provider business mailing address

7024 SEVILLE AVE STE E
HUNTINGTON PARK CA
90255-4969
US

V. Phone/Fax

Practice location:
  • Phone: 323-587-1200
  • Fax: 323-587-1300
Mailing address:
  • Phone: 323-587-1200
  • Fax: 323-587-1300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AKSHAR PATEL
Title or Position: SOLE DIRECTOR
Credential:
Phone: 323-587-1200