Healthcare Provider Details
I. General information
NPI: 1407525264
Provider Name (Legal Business Name): LA PAZ PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/07/2021
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2355 N OXNARD BLVD
OXNARD CA
93036-2065
US
IV. Provider business mailing address
2355 N OXNARD BLVD
OXNARD CA
93036-2065
US
V. Phone/Fax
- Phone: 805-485-1991
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ARTURO
DOMINGUEZ
Title or Position: OWNER
Credential: PHARMD
Phone: 805-288-3643