Healthcare Provider Details

I. General information

NPI: 1134132020
Provider Name (Legal Business Name): MIV CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19000 HAWTHORNE BLVD SUITE 302
TORRANCE CA
90503
US

IV. Provider business mailing address

19000 HAWTHORNE BLVD SUITE 302
TORRANCE CA
90503
US

V. Phone/Fax

Practice location:
  • Phone: 310-370-7483
  • Fax: 310-370-7726
Mailing address:
  • Phone: 310-370-7483
  • Fax: 310-370-7726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY46138
License Number StateCA

VIII. Authorized Official

Name: MR. MICHAEL VOLDMAN
Title or Position: PRESIDENT
Credential:
Phone: 310-370-7483