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General NPI Number Information
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NPI Number | 1093875577
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Entity Type | Organization
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Legal Business Name | LOS ANGELES DRUGS
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3030 W OLYMPIC BLVD SUITE 118
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City | LOS ANGELES
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State | CA
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Zip | 90006-6501
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Country | US
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Telephone | 213-387-3030
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Fax | 213-739-2020
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Provider Business Mailing Address
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Address Line | 3030 WEST OLYMPIC BLVD SUITE 118
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City | LOS ANGELES
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State | CA
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Zip | 90006
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Country | US
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Telephone | 213-387-3030
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Fax | 213-739-2020
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Authorized Official
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Title or Position | OWNER
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Name | JAY IM
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Credential |
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Telephone | 213-387-3030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY43829
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License Number State | CA
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