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General NPI Number Information
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NPI Number | 1104169531
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Entity Type | Organization
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Legal Business Name | TRATT
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Dates
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Enumeration Date | 04/04/2013
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 1135 S SAN GABRIEL BLVD #2
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City | SAN GABRIEL
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State | CA
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Zip | 91776-3114
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Country | US
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Telephone | 626-872-0181
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Fax | 626-872-0182
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Provider Business Mailing Address
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Address Line | 1135 S SAN GABRIEL BLVD #2
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City | SAN GABRIEL
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State | CA
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Zip | 91776-3114
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Country | US
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Telephone | 626-872-0181
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Fax | 626-872-0182
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Authorized Official
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Title or Position | OWNER/PIC
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Name | YU-LING BENJAMIN LIAO
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Credential |
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Telephone | 626-872-0181
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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 |
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License Number State |
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