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General NPI Number Information
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NPI Number | 1346611225
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Entity Type | Organization
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Legal Business Name | KL PHARMACY CORPORATION
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Dates
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Enumeration Date | 10/17/2015
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Last Update Date | 03/08/2022
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Provider Practice Location Address
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Address Line | 4718 W 1ST ST STE 101
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City | SANTA ANA
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State | CA
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Zip | 92703-3106
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Country | US
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Telephone | 657-231-6850
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Fax | 888-671-7563
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Provider Business Mailing Address
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Address Line | 4718 W 1ST ST STE 101
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City | SANTA ANA
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State | CA
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Zip | 92703-3106
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Country | US
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Telephone | 657-231-6850
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Fax | 888-671-7563
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Authorized Official
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Title or Position | CEO/PHARMACIST
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Name | MRS. KATRINA LAM
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Credential | PHARM.D
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Telephone | 714-856-7925
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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 | 54227
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License Number State | CA
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