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General NPI Number Information
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NPI Number | 1699794883
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Entity Type | Organization
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Legal Business Name | HEALTHNET PLUS
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 03/11/2014
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Provider Practice Location Address
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Address Line | 1745 W 17TH ST
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City | SANTA ANA
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State | CA
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Zip | 92706-2378
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Country | US
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Telephone | 714-558-0131
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Fax | 714-558-0262
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Provider Business Mailing Address
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Address Line | 1745 W 17TH ST STE A
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City | SANTA ANA
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State | CA
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Zip | 92706-2379
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Country | US
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Telephone | 714-558-0131
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Fax | 714-558-0262
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MS. IQTADARA MALIK
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Credential |
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Telephone | 714-558-0131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY47004
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License Number State | CA
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