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General NPI Number Information
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NPI Number | 1184765695
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Entity Type | Organization
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Legal Business Name | NATICO INC
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 03/20/2015
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Provider Practice Location Address
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Address Line | 12526 WESTMINSTER AVE STE B
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City | SANTA ANA
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State | CA
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Zip | 92706-2166
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Country | US
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Telephone | 714-554-1111
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Fax | 714-554-7777
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Provider Business Mailing Address
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Address Line | 12526 WESTMINSTER AVE STE B
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City | SANTA ANA
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State | CA
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Zip | 92706-2166
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Country | US
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Telephone | 714-554-1111
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Fax | 714-554-7777
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Authorized Official
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Title or Position | PRESIDENT
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Name | PHUONG NGUYEN
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Credential | RPH
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Telephone | 714-554-1111
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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 | PHY46902
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License Number State | CA
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