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General NPI Number Information
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NPI Number | 1063760734
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Entity Type | Organization
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Legal Business Name | GOLDEN SUNRISE PHARMACEUTICAL, INC.
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Dates
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Enumeration Date | 08/28/2012
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Last Update Date | 08/28/2012
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Provider Practice Location Address
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Address Line | 560 W PUTNAM AVE STE 2
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City | PORTERVILLE
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State | CA
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Zip | 93257-3269
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Country | US
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Telephone | 559-781-0658
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Fax | 559-788-2946
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Provider Business Mailing Address
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Address Line | 560 W PUTNAM AVE STE 2
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City | PORTERVILLE
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State | CA
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Zip | 93257-3269
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Country | US
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Telephone | 559-781-0658
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Fax | 559-788-2946
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. HUU S. TIEU
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Credential |
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Telephone | 559-781-0658
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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 |
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License Number State | CA
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