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General NPI Number Information
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NPI Number | 1689733784
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Entity Type | Organization
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Legal Business Name | BRIAN B MIN
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 1935 W VALLEY BLVD
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City | ALHAMBRA
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State | CA
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Zip | 91803-2346
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Country | US
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Telephone | 626-289-4343
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Fax | 626-289-9336
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Provider Business Mailing Address
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Address Line | 1935 W VALLEY BLVD
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City | ALHAMBRA
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State | CA
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Zip | 91803-2346
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Country | US
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Telephone | 626-289-4343
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Fax | 626-289-9336
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Authorized Official
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Title or Position | OWNER PHARMACIST
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Name | BRIAN B MIN
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Credential |
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Telephone | 626-289-4343
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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 | RPH35960
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 48957
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHY48957
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License Number State | CA
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