Healthcare Provider Details

I. General information

NPI: 1053904326
Provider Name (Legal Business Name): GILBERT PAPILLA CPHT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2021
Last Update Date: 02/17/2021
Certification Date: 02/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3326 BRANDY WINE WAY
TORRANCE CA
90505-7104
US

IV. Provider business mailing address

3326 BRANDY WINE WAY
TORRANCE CA
90505-7104
US

V. Phone/Fax

Practice location:
  • Phone: 310-940-1771
  • Fax:
Mailing address:
  • Phone: 310-940-1771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number76210
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: