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General NPI Number Information
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NPI Number | 1831180926
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Entity Type | Organization
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Legal Business Name | A.M.G. PHARMACEUTICAL INC.
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Dates
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Enumeration Date | 10/29/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 27 ROSY FINCH LN
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City | ALISO VIEJO
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State | CA
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Zip | 92656-1857
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Country | US
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Telephone | 949-306-6582
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Fax |
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Provider Business Mailing Address
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Address Line | 27 ROSY FINCH LN
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City | ALISO VIEJO
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State | CA
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Zip | 92656-1857
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Country | US
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Telephone | 949-306-6582
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDREA MOHSEN GOMAROONI
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Credential | PHARM.D., CH.E.
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Telephone | 949-306-6582
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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 | 2004014854
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 57164
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License Number State | CA
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