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General NPI Number Information
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NPI Number | 1841784154
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Entity Type | Organization
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Legal Business Name | BELLA TERRA PHARMACY INC
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 16121 BEACH BLVD
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-3804
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Country | US
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Telephone | 949-220-2554
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Fax | 949-438-6044
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Provider Business Mailing Address
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Address Line | 16121 BEACH BLVD
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-3804
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Country | US
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Telephone | 949-220-2554
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Fax | 949-438-6044
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Authorized Official
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Title or Position | OWNER
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Name | TRAMANH N. TON
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Credential | PHARMD
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Telephone | 714-675-0453
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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 | A297116
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License Number State | CA
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