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General NPI Number Information
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NPI Number | 1366947848
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Entity Type | Organization
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Legal Business Name | JAYS DRUG
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Dates
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Enumeration Date | 03/27/2018
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 3154 W OLYMPIC BLVD STE D
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City | LOS ANGELES
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State | CA
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Zip | 90006-2414
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Country | US
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Telephone | 323-731-4696
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Fax | 323-731-0285
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Provider Business Mailing Address
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Address Line | 3154 W OLYMPIC BLVD STE D
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City | LOS ANGELES
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State | CA
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Zip | 90006-2414
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Country | US
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Telephone | 323-731-4696
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Fax | 323-731-0285
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Authorized Official
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Title or Position | PHARMACY MANAGER /OWNER
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Name | JAE KUAEN SHIN
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Credential | PHARMACIST
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Telephone | 323-731-4696
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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 | 36105
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License Number State | CA
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