MEDICARE: WILSHIRE PHARMCARE, INC.

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	333600000X	Pharmacy
2	3336H0001X	Home Infusion Therapy Pharmacy

General Provider Information

NPI Number	:	1447253448
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILSHIRE PHARMCARE, INC.

Provider Business Mailing Address
First Line	:	26611 CABOT RD. STE B
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-7018
Country	:	US
Telephone Number	:	949-348-7900
Fax Number	:	714-701-1195

Provider Business Practice Location Address
First Line	:	4420 E MIRALOMA AVE STE F
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92807-1838
Country	:	US
Telephone Number	:	714-701-1192
Fax Number	:	714-701-1195

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	SAMEL K LEE
Credential	:	PHARMD
Telephone Number	:	949-348-7900

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	09/02/2025

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