Healthcare Provider Details

I. General information

NPI: 1033496393
Provider Name (Legal Business Name): LAI FONG MOY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LILY MOY PHARMD

II. Dates (important events)

Enumeration Date: 11/14/2011
Last Update Date: 11/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 W 6TH ST
LOS ANGELES CA
90020-5001
US

IV. Provider business mailing address

3201 W 6TH ST
LOS ANGELES CA
90020-5001
US

V. Phone/Fax

Practice location:
  • Phone: 213-251-0179
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH61130
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: