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General NPI Number Information
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NPI Number | 1245397512
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Entity Type | Organization
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Legal Business Name | UNITED MEDCARE
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 05/11/2021
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Provider Practice Location Address
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Address Line | 1127 WILSHIRE BLVD STE 201
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City | LOS ANGELES
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State | CA
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Zip | 90017-3903
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Country | US
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Telephone | 213-482-0644
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Fax | 213-482-0668
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Provider Business Mailing Address
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Address Line | 1127 WILSHIRE BLVD STE 201
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City | LOS ANGELES
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State | CA
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Zip | 90017-3901
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Country | US
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Telephone | 213-482-0644
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Fax | 213-482-0668
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Authorized Official
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Title or Position | PRESIDENT
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Name | FUNG-WAH CHRIS RUIZ
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Credential |
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Telephone | 213-482-0644
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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 | 55401
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License Number State | CA
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