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General NPI Number Information
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NPI Number | 1972013480
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Entity Type | Organization
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Legal Business Name | CMC ENTERPRISE INC
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Dates
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Enumeration Date | 10/10/2017
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Last Update Date | 12/22/2020
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Provider Practice Location Address
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Address Line | 1634 W SUNSET BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90026-4227
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Country | US
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Telephone | 213-341-1411
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Fax | 213-395-0711
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Provider Business Mailing Address
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Address Line | 2930 ROWENA AVE UNIT 4
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City | LOS ANGELES
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State | CA
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Zip | 90039-2191
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Country | US
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Telephone | 213-369-6940
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Fax |
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Authorized Official
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Title or Position | PHARMACIST/CEO
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Name | DR. CRAIG K YOO
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Credential | PHARM.D.
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Telephone | 213-341-1411
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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 | 55666
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License Number State | CA
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