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General NPI Number Information
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NPI Number | 1740679901
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Entity Type | Organization
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Legal Business Name | CHINO HILLS MED-PLAZA PHARMACY INC
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Dates
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Enumeration Date | 01/12/2015
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Last Update Date | 02/27/2015
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Provider Practice Location Address
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Address Line | 3110 CHINO AVE STE 100
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City | CHINO HILLS
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State | CA
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Zip | 91709-1294
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Country | US
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Telephone | 909-465-6562
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Fax | 909-465-9260
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Provider Business Mailing Address
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Address Line | 3110 CHINO AVE SUITE 100
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City | CHINO HILLS
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State | CA
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Zip | 91709-1211
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Country | US
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Telephone | 909-465-6562
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Fax | 909-465-9260
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Authorized Official
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Title or Position | PRESIDENT/PIC
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Name | RAANA SIDKY
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Credential |
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Telephone | 909-465-6562
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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 | 52534
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License Number State | CA
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