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General NPI Number Information
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NPI Number | 1225135114
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Entity Type | Organization
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Legal Business Name | MAXSON MEDICAL PHARMACY INC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 933 S SUNSET AVE STE 107
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City | WEST COVINA
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State | CA
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Zip | 91790-3414
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Country | US
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Telephone | 626-338-1143
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Fax | 626-962-8007
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Provider Business Mailing Address
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Address Line | 933 S SUNSET AVE STE 107
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City | WEST COVINA
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State | CA
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Zip | 91790-3414
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Country | US
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Telephone | 626-338-1143
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Fax | 626-962-8007
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE/PRESIDENT/CEO
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Name | DR. KING LAW
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Credential | PHARMD
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Telephone | 626-338-1143
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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 | PHY33095
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License Number State | CA
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