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General NPI Number Information
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NPI Number | 1265574149
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Entity Type | Organization
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Legal Business Name | M&I ENTERPRISES,INC
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2750 E-WASHINGTON BLVD SUITE 150
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City | PASADENA
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State | CA
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Zip | 91107
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Country | US
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Telephone | 626-791-7595
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Fax | 626-791-3564
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Provider Business Mailing Address
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Address Line | 2750 E-WASHINGTON BLVD. SUITE 150
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City | PASADENA
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State | CA
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Zip | 91107
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Country | US
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Telephone | 626-791-7595
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Fax | 626-791-3564
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MAT(MAN) Y JUNG
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Credential | PHARMACIST
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Telephone | 626-791-7595
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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 | 39452
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License Number State | CA
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