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General NPI Number Information
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NPI Number | 1225207764
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Entity Type | Organization
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Legal Business Name | JAMES SONG PHARM.D. PHARMACY INC.
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Dates
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Enumeration Date | 02/28/2008
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Last Update Date | 06/08/2021
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Provider Practice Location Address
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Address Line | 4220 W 3RD ST STE 100
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City | LOS ANGELES
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State | CA
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Zip | 90020-3450
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Country | US
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Telephone | 231-384-3405
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Fax | 213-384-3406
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Provider Business Mailing Address
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Address Line | 4220 W 3RD ST STE 100
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City | LOS ANGELES
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State | CA
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Zip | 90020-3450
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Country | US
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Telephone | 231-384-3405
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Fax | 213-384-3406
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Authorized Official
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Title or Position | OWNER
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Name | JAMES SONG
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Credential | PHRMD
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Telephone | 661-755-1632
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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 | PHY49002
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License Number State | CA
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