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Organization
TARGET
Active
Organization
TARGET
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DORIS FONG (PHARMACY MANAGER)
(626) 280-4908
Entity
Organization
Contact information
Practice address
3600 ROSEMEAD BLVD, ROSEMEAD, CA 91700
(626) 280-4908
Mailing address
3600 ROSEMEAD BLVD, T-1411, ROSEMEAD, CA 91770-2066
(626) 280-4908
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
54911
CA
Other
Enumeration date
06/10/2011
Last updated
06/10/2011
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