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General NPI Number Information
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NPI Number | 1134283435
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Entity Type | Individual
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Provider Name | MARIA SUKAMTO PHARMACIST
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Gender | Female
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2911 BEVERLY BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90057-1025
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Country | US
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Telephone | 213-480-6588
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Fax | 213-480-6582
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Provider Business Mailing Address
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Address Line | 1041 MOONBEAM DR
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City | MONTEREY PARK
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State | CA
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Zip | 91754-5229
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Country | US
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Telephone | 323-261-1734
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH 39288
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License Number State | CA
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