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General NPI Number Information
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NPI Number | 1689925588
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Entity Type | Organization
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Legal Business Name | MALUK ENTERPRISING CORPORATION
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Dates
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Enumeration Date | 10/02/2012
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Last Update Date | 11/18/2012
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Provider Practice Location Address
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Address Line | 123 E VALLEY BLVD #105
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City | SAN GABRIEL
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State | CA
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Zip | 91776-3599
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Country | US
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Telephone | 626-571-2290
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Fax | 626-571-2291
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Provider Business Mailing Address
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Address Line | 123 E VALLEY BLVD #105
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City | SAN GABRIEL
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State | CA
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Zip | 91776-3599
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Country | US
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Telephone | 626-571-2290
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Fax | 626-571-2291
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Authorized Official
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Title or Position | PRESIDENT/PIC
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Name | MR. HUNGTIN LUK
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Credential | RPH
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Telephone | 626-571-2290
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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 | PHY 50971
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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 | PHY 50971
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License Number State | CA
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