MEDICARE: CHINATOWN PHARMACY 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	3336C0003X	Community/Retail Pharmacy		CA

General Provider Information

NPI Number	:	1558726455
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHINATOWN PHARMACY INC

Provider Business Mailing Address
First Line	:	709 N HILL ST
Second Line	:	#21
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-2361
Country	:	US
Telephone Number	:	213-687-9999
Fax Number	:	213-687-9998

Provider Business Practice Location Address
First Line	:	709 N HILL ST
Second Line	:	#21
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-2361
Country	:	US
Telephone Number	:	213-687-9999
Fax Number	:	213-687-9998

Authorized Official
Title or Position	:	PRESIDENT/PIC
Name	:	MR. JIMMY C. UNG
Credential	:	PHARM D
Telephone Number	:	213-687-9999

Provider Enumeration Date	:	12/18/2015
Last Update Date	:	12/18/2015

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