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General NPI Number Information
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NPI Number | 1821349267
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Entity Type | Organization
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Legal Business Name | CAL OAKS PHARMACY, INC
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Dates
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Enumeration Date | 09/25/2012
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Last Update Date | 09/25/2012
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Provider Practice Location Address
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Address Line | 2010 HUNTINGTON DR SUITE A
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City | SAN MARINO
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State | CA
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Zip | 91108-2022
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Country | US
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Telephone | 626-795-5956
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Fax | 626-795-4998
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Provider Business Mailing Address
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Address Line | 55 E CALIFORNIA BLVD SUITE 103
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City | PASADENA
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State | CA
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Zip | 91105-3954
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Country | US
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Telephone | 626-795-5956
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Fax | 626-795-4998
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Authorized Official
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Title or Position | CEO
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Name | DR. MINAH KIM
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Credential | PHARM. D.
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Telephone | 626-795-5956
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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 |
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License Number State |
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