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General NPI Number Information
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NPI Number | 1770747768
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Entity Type | Individual
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Provider Name | MARY AN BANG PHARM.D., BCOP
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Gender | Female
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Dates
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Enumeration Date | 07/18/2008
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 12254 BELLFLOWER BLVD
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City | DOWNEY
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State | CA
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Zip | 90242-2804
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Country | US
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Telephone | 310-871-6305
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Fax |
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Provider Business Mailing Address
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Address Line | 20629 W CHESTNUT CIR
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City | PORTER RANCH
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State | CA
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Zip | 91326-4949
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Country | US
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Telephone | 310-871-6305
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 60125
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License Number State | CA
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