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General NPI Number Information
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NPI Number | 1528283348
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Entity Type | Organization
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Legal Business Name | JUANA E VALDEZ
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 08/23/2023
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Provider Practice Location Address
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Address Line | 9910 LONG BEACH BLVD STE F
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City | LYNWOOD
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State | CA
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Zip | 90262-1561
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Country | US
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Telephone | 323-249-8497
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Fax | 323-249-0038
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Provider Business Mailing Address
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Address Line | 9910 LONG BEACH BLVD STE F
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City | LYNWOOD
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State | CA
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Zip | 90262-1561
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Country | US
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Telephone | 323-249-8497
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Fax | 323-249-0038
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JUANA E VALDEZ
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Credential |
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Telephone | 323-249-8497
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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 | PHY47170
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License Number State | CA
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