1285075200 NPI number — CALI CARE PHARMACY INC

Table of content: MISS LINDA HERNANDEZ RPH (NPI 1912115304)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285075200 NPI number — CALI CARE PHARMACY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CALI CARE PHARMACY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285075200
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/13/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10278 WESTMINSTER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GARDEN GROVE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92843-4830
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-537-7291
Provider Business Mailing Address Fax Number:
714-537-7261

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10278 WESTMINSTER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GARDEN GROVE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92843-4830
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-537-7291
Provider Business Practice Location Address Fax Number:
714-537-7261
Provider Enumeration Date:
07/08/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TRINH
Authorized Official First Name:
MEGAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/PIC
Authorized Official Telephone Number:
714-537-7291

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)