MEDICARE: CAMLAI LY

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	183700000X	Pharmacy Technician	36863	CA

General Provider Information

NPI Number	:	1841681145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMLAI LY

Provider Business Mailing Address
First Line	:	10938 LOTUS DR
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-4989
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5015 W EDINGER AVE STE B
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-1968
Country	:	US
Telephone Number	:	707-980-9518
Fax Number	:

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

Provider Enumeration Date	:	02/09/2015
Last Update Date	:	02/09/2015

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Directions to “ CAMLAI LY ” Practice Location

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