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General NPI Number Information
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NPI Number | 1548326424
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Entity Type | Organization
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Legal Business Name | HERBERT Y H & JEAN C N KING
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 12/07/2010
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Provider Practice Location Address
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Address Line | 1060 E FOOTHILL BLVD STE 101
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City | UPLAND
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State | CA
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Zip | 91786-4027
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Country | US
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Telephone | 909-982-1778
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Fax | 909-981-3418
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Provider Business Mailing Address
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Address Line | 1060 E FOOTHILL BLVD STE 101
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City | UPLAND
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State | CA
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Zip | 91786-4027
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Country | US
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Telephone | 909-982-1778
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Fax | 909-981-3418
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Authorized Official
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Title or Position | PHARM
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Name | JEAN KING
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Credential | PHARMD
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Telephone | 909-982-1778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY34972
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License Number State | CA
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