Healthcare Provider Details

I. General information

NPI: 1548576317
Provider Name (Legal Business Name): CREATIVE COMPOUNDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2010
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 W LAKE CENTER DR STE B
SANTA ANA CA
92704-6900
US

IV. Provider business mailing address

3500 W LAKE CENTER DR STE B
SANTA ANA CA
92704-6900
US

V. Phone/Fax

Practice location:
  • Phone: 949-642-0106
  • Fax: 949-642-5039
Mailing address:
  • Phone: 949-642-0106
  • Fax: 949-642-5039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL HUA
Title or Position: CEO/PIC
Credential: PHARMD.
Phone: 949-642-0106