Healthcare Provider Details

I. General information

NPI: 1891912788
Provider Name (Legal Business Name): COUNTY OF LOS ANGELES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 01/05/2024
Certification Date: 01/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 CHESTNUT AVE PHARMACY DEPARTMENT
LONG BEACH CA
90813-2944
US

IV. Provider business mailing address

1333 CHESTNUT AVE
LONG BEACH CA
90813-2944
US

V. Phone/Fax

Practice location:
  • Phone: 562-599-8723
  • Fax: 562-591-3348
Mailing address:
  • Phone: 562-599-8723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHE32435
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PETER CHEN
Title or Position: PHARMACY OFFICER
Credential:
Phone: 562-599-8723