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General NPI Number Information
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NPI Number | 1427584044
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Entity Type | Organization
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Legal Business Name | KMTV INC.
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Dates
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Enumeration Date | 05/02/2017
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Last Update Date | 04/14/2022
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Provider Practice Location Address
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Address Line | 825 WASHINGTON BLVD. STE. C
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City | MONTEBELLO
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State | CA
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Zip | 90640-6179
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Country | US
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Telephone | 323-278-0016
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Fax | 323-278-0019
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Provider Business Mailing Address
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Address Line | 825 WASHINGTON BLVD. STE. C
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City | MONTEBELLO
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State | CA
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Zip | 90640-6179
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Country | US
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Telephone | 323-278-0016
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Fax | 323-278-0019
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Authorized Official
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Title or Position | CEO/CFO/SEC./DIR.
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Name | MINH DO
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Credential |
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Telephone | 408-821-7425
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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 | 55542
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License Number State | CA
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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