Healthcare Provider Details

I. General information

NPI: 1023010725
Provider Name (Legal Business Name): KING PHARMACY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 02/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2707 WHITTIER BLVD
LOS ANGELES CA
90023-1441
US

IV. Provider business mailing address

2707 WHITTIER BLVD
LOS ANGELES CA
90023-1441
US

V. Phone/Fax

Practice location:
  • Phone: 323-262-8845
  • Fax: 323-262-8841
Mailing address:
  • Phone: 323-262-8845
  • Fax: 323-262-8841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY45679
License Number StateCA

VIII. Authorized Official

Name: MRS. UDING YULINTA
Title or Position: PHARMACIST IN CHARGE
Credential: R.PH.
Phone: 323-262-8845