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General NPI Number Information
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NPI Number | 1366084063
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Entity Type | Organization
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Legal Business Name | PONTUS HEALTHCARE INC
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Dates
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Enumeration Date | 10/14/2019
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 1203 N AVALON BLVD SUITE A
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City | WILMINGTON
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State | CA
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Zip | 90744-2646
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Country | US
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Telephone | 310-549-1000
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Fax | 310-549-7000
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Provider Business Mailing Address
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Address Line | 1203 N AVALON BLVD SUITE A
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City | WILMINGTON
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State | CA
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Zip | 90744-2646
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Country | US
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Telephone | 310-549-1000
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Fax | 310-549-7000
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Authorized Official
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Title or Position | CEO
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Name | LILIA XU
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Credential | PHARM D.
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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