Healthcare Provider Details

I. General information

NPI: 1770583387
Provider Name (Legal Business Name): CALIFORNIA MEDICAL PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 03/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 W TEMPLE ST
LOS ANGELES CA
90026-4917
US

IV. Provider business mailing address

2201 W TEMPLE ST
LOS ANGELES CA
90026-4917
US

V. Phone/Fax

Practice location:
  • Phone: 213-413-2343
  • Fax: 213-413-1354
Mailing address:
  • Phone: 213-413-2343
  • Fax: 213-413-1354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: THOMAS J LIAUTAUD
Title or Position: PRESIDENT
Credential: RPH
Phone: 213-413-2343