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General NPI Number Information
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NPI Number | 1679114896
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Entity Type | Organization
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Legal Business Name | K C B PHARMACY INC
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Dates
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Enumeration Date | 09/30/2019
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 3378 S BRISTOL ST
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City | SANTA ANA
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State | CA
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Zip | 92704-8203
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Country | US
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Telephone | 714-755-7002
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Fax | 714-755-7613
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Provider Business Mailing Address
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Address Line | 3378 S BRISTOL ST
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City | SANTA ANA
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State | CA
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Zip | 92704-8203
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Country | US
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Telephone | 714-755-7002
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Fax | 714-755-7613
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Authorized Official
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Title or Position | PIC/CEO
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Name | ANIL BHALODIA
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Credential |
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Telephone | 714-755-7002
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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