Healthcare Provider Details

I. General information

NPI: 1114239332
Provider Name (Legal Business Name): CALIFORNIA SPECIALTY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2010
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12110 HADLEY ST STE B
WHITTIER CA
90601-3912
US

IV. Provider business mailing address

12110 HADLEY ST STE B
WHITTIER CA
90601-3912
US

V. Phone/Fax

Practice location:
  • Phone: 877-802-7779
  • Fax: 866-853-6555
Mailing address:
  • Phone: 877-802-7779
  • Fax: 866-853-6555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH24882
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number54320
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPMP-666
License Number StateHI
# 6
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. GEORGE WORTHINGTON KRIDNER IV
Title or Position: PRESIDENT/CEO
Credential: PHARMD
Phone: 714-981-6871