Healthcare Provider Details

I. General information

NPI: 1023051802
Provider Name (Legal Business Name): BESTCARE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 08/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 CLARK AVE
LONG BEACH CA
90815-2521
US

IV. Provider business mailing address

17573 LIVE OAK CIR
FOUNTAIN VALLEY CA
92708-4413
US

V. Phone/Fax

Practice location:
  • Phone: 562-494-1371
  • Fax: 562-494-1831
Mailing address:
  • Phone: 714-856-3667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY47232
License Number StateCA

VIII. Authorized Official

Name: MY DOAN THI VO
Title or Position: OWNER
Credential:
Phone: 714-856-3667