Healthcare Provider Details

I. General information

NPI: 1942301098
Provider Name (Legal Business Name): PAI AND CHAN PHARMACY CORP. II
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 S VERMONT AVE
LOS ANGELES CA
90005-1520
US

IV. Provider business mailing address

770 S VERMONT AVE
LOS ANGELES CA
90005-1520
US

V. Phone/Fax

Practice location:
  • Phone: 213-383-2211
  • Fax: 213-674-2458
Mailing address:
  • Phone: 213-383-2211
  • Fax: 213-674-2458

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 Number51127
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/CEO/PIC
Credential:
Phone: 213-383-2211