Healthcare Provider Details

I. General information

NPI: 1851385983
Provider Name (Legal Business Name): PINE DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2005
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15663 BROOKHURST ST
WESTMINSTER CA
92683-7556
US

IV. Provider business mailing address

15663 BROOKHURST ST
WESTMINSTER CA
92683-7556
US

V. Phone/Fax

Practice location:
  • Phone: 714-839-1267
  • Fax: 714-839-5871
Mailing address:
  • Phone: 714-839-1267
  • Fax: 714-839-5871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHA446090
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. DAN DANG
Title or Position: PRESIDENT
Credential: RPH
Phone: 714-839-1267