Healthcare Provider Details

I. General information

NPI: 1881329977
Provider Name (Legal Business Name): ANDREW SOLANZO KOJO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2022
Last Update Date: 07/21/2022
Certification Date: 07/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15210 ROSECRANS AVE
LA MIRADA CA
90638-4735
US

IV. Provider business mailing address

17800 COLIMA RD APT 711
ROWLAND HEIGHTS CA
91748-1743
US

V. Phone/Fax

Practice location:
  • Phone: 714-228-0204
  • Fax:
Mailing address:
  • Phone: 408-505-2113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number85208
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: