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General NPI Number Information
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NPI Number | 1023171790
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Entity Type | Organization
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Legal Business Name | CALIFORNIA PHARMACY
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9304 S BROADWAY
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City | LOS ANGELES
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State | CA
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Zip | 90003-4044
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Country | US
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Telephone | 323-777-5853
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Fax | 323-777-9465
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Provider Business Mailing Address
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Address Line | 9304 S BROADWAY
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City | LOS ANGELES
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State | CA
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Zip | 90003-4044
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Country | US
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Telephone | 323-777-5853
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Fax | 323-777-9465
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Authorized Official
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Title or Position | PHARMACIST
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Name | TRACY LOVELACE
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Credential |
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Telephone | 323-777-5853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 37066
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License Number State | CA
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