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Organization
CALIFORNIA PHARMACY
Active
Organization
CALIFORNIA PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY LOVELACE (PHARMACIST)
(323) 777-5853
Entity
Organization
Contact information
Practice address
9304 S BROADWAY, LOS ANGELES, CA 90003-4044
(323) 777-5853
(323) 777-9465
Mailing address
9304 S BROADWAY, LOS ANGELES, CA 90003-4044
(323) 777-5853
(323) 777-9465
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
37066
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0578116
NABP
CA
05
—
PHA227730
—
CA
Enumeration date
12/18/2006
Last updated
08/22/2020
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