Healthcare Provider Details

I. General information

NPI: 1538566039
Provider Name (Legal Business Name): PAI AND CHAN PHARMACY CORP II
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2014
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1047 N STATE ST
LOS ANGELES CA
90033-1332
US

IV. Provider business mailing address

1047 N STATE ST
LOS ANGELES CA
90033-1332
US

V. Phone/Fax

Practice location:
  • Phone: 323-226-0237
  • Fax: 323-226-0261
Mailing address:
  • Phone: 323-226-0237
  • Fax: 323-226-0261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number52013
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JAMES PAI
Title or Position: PRESIDENT/PIC
Credential:
Phone: 323-226-0237