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General NPI Number Information
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NPI Number | 1790890309
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Entity Type | Organization
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Legal Business Name | KML PHARMACY INC
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1655 S DE ANZA BLVD STE 2
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City | CUPERTINO
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State | CA
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Zip | 95014-5319
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Country | US
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Telephone | 408-873-8123
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Fax |
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Provider Business Mailing Address
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Address Line | 1655 S DE ANZA BLVD STE 2
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City | CUPERTINO
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State | CA
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Zip | 95014-5319
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | KAMING LAU
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Credential |
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Telephone | 408-873-8123
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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 | PHY48232
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License Number State | CA
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