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General NPI Number Information
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NPI Number | 1033594015
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Entity Type | Organization
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Legal Business Name | FEEL GOOD COMPOUNDERS
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Dates
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Enumeration Date | 07/20/2015
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Last Update Date | 07/20/2015
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Provider Practice Location Address
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Address Line | 411 DONDEE ST STE C
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City | PACIFICA
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State | CA
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Zip | 94044-3278
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Country | US
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Telephone | 650-898-8221
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Fax | 650-898-8147
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Provider Business Mailing Address
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Address Line | 411 DONDEE ST STE C
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City | PACIFICA
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State | CA
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Zip | 94044-3278
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Country | US
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Telephone | 650-898-8221
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Fax | 650-898-8147
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | EDDIE LAU
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Credential |
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Telephone | 650-898-8221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PHY52495
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License Number State | CA
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