MEDICARE: MRS. DAISY KWOK RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	29359	CA

General Provider Information

NPI Number	:	1164741344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DAISY KWOK RPH

Provider Business Mailing Address
First Line	:	951 N HARBOR BLVD
Second Line	:
City	:	LA HABRA
State	:	CA
Zip	:	90631-3103
Country	:	US
Telephone Number	:	562-697-4718
Fax Number	:	562-697-4858

Provider Business Practice Location Address
First Line	:	951 N HARBOR BLVD
Second Line	:
City	:	LA HABRA
State	:	CA
Zip	:	90631-3103
Country	:	US
Telephone Number	:	562-697-4718
Fax Number	:	562-697-4858

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2010
Last Update Date	:	05/27/2010

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