Healthcare Provider Details

I. General information

NPI: 1841303542
Provider Name (Legal Business Name): CAL OASIS CORPOATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19041 COLIMA RD
ROWLAND HEIGHTS CA
91748-2922
US

IV. Provider business mailing address

19041 COLIMA RD
ROWLAND HEIGHTS CA
91748-2922
US

V. Phone/Fax

Practice location:
  • Phone: 800-905-5562
  • Fax: 800-971-0772
Mailing address:
  • Phone: 800-905-5562
  • Fax: 800-971-0772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY47548
License Number StateCA

VIII. Authorized Official

Name: MR. RICHARD PAUL LACSON
Title or Position: SECRETARY
Credential:
Phone: 800-905-5562