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Organization
UNITED MEDCARE
Active
Organization
UNITED MEDCARE
Active
Other names
Phoenix Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
FUNG-WAH LAM (PRESIDENT)
(213) 482-0644
Entity
Organization
Contact information
Practice address
1127 WILSHIRE BLVD STE 201, LOS ANGELES, CA 90017-3903
(213) 482-0644
(213) 482-0668
Mailing address
1127 WILSHIRE BLVD STE 201, LOS ANGELES, CA 90017-3903
(213) 482-0644
(213) 482-0668
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
55401
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2176314
PK
—
Enumeration date
03/09/2018
Last updated
06/22/2021
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