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General NPI Number Information
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NPI Number | 1114239332
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Entity Type | Organization
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Legal Business Name | CALIFORNIA SPECIALTY PHARMACY LLC
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Dates
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Enumeration Date | 07/02/2010
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 12110 HADLEY ST STE B
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City | WHITTIER
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State | CA
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Zip | 90601-3912
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Country | US
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Telephone | 877-802-7779
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Fax | 866-853-6555
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Provider Business Mailing Address
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Address Line | 12110 HADLEY ST STE B
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City | WHITTIER
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State | CA
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Zip | 90601-3912
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Country | US
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Telephone | 877-802-7779
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Fax | 866-853-6555
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. GEORGE WORTHINGTON KRIDNER IV
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Credential | PHARMD
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Telephone | 714-981-6871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PH24882
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License Number State | FL
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Taxonomy #2
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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 |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 54320
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PMP-666
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License Number State | HI
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Taxonomy #6
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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