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General NPI Number Information
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NPI Number | 1689730954
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Entity Type | Organization
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Legal Business Name | MKA PHARMACY CORPORATION
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 14571 MAGNOLIA ST STE 104
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City | WESTMINSTER
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State | CA
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Zip | 92683-5574
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Country | US
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Telephone | 714-893-2697
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Fax | 714-893-3897
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Provider Business Mailing Address
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Address Line | 14571 MAGNOLIA ST STE 104
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City | WESTMINSTER
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State | CA
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Zip | 92683-5574
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Country | US
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Telephone | 714-893-2697
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Fax | 714-893-3897
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Authorized Official
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Title or Position | CEO
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Name | KEVIN HOANG DINH
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Credential | PHARM.D.
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Telephone | 714-893-2697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | PHY48298
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License Number State | CA
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