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General NPI Number Information
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NPI Number | 1972584118
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Entity Type | Organization
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Legal Business Name | REINA SY
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 08/01/2012
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Provider Practice Location Address
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Address Line | 7220 ROSEMEAD BLVD STE 202-7
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City | SAN GABRIEL
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State | CA
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Zip | 91775-1377
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Country | US
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Telephone | 323-344-1815
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Fax |
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Provider Business Mailing Address
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Address Line | 4526 EAGLE ROCK BLVD STE 4
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City | LOS ANGELES
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State | CA
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Zip | 90041-3285
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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 | PHARMACIST
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Name | REINA SY
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Credential |
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Telephone | 323-459-2264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 46995
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License Number State | CA
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