Organization · NPI-2

6122pharmacy

Pharmacy, Community/Retail Pharmacy · Los Angeles, CA

NPI number1124141270
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1124141270
Entity type
Organization (NPI-2)
Legal business name
6122pharmacy
Organization subpart
No
Enumeration date
Apr 6, 2007
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail PharmacyPHY30457CAYes

Practice location

6122 Whittier Blvd
Los Angeles, CA 90022-4504

Phone 323-725-1250 · Fax 323-726-9091

Mailing address

6122 Whittier Blvd
Los Angeles, CA 90022-4504

Phone 323-725-1250 · Fax 323-726-9091

Authorized official

Carl Kong
President
3237251250

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