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General NPI Number Information
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NPI Number | 1255332565
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Entity Type | Organization
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Legal Business Name | CANOGA PHARMACY,INC
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9646 GARVEY AVE SUITE 103
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City | S EL MONTE
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State | CA
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Zip | 91733-1098
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Country | US
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Telephone | 626-575-6012
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Fax | 626-575-6024
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Provider Business Mailing Address
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Address Line | 9646 GARVEY AVE SUITE 103
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City | S EL MONTE
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State | CA
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Zip | 91733-1098
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Country | US
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Telephone | 626-575-6012
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Fax | 626-575-6024
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MRS. THUY THI NGUYEN
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Credential | PHARMACIST
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Telephone | 626-575-6012
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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 | RPH48165
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License Number State | CA
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