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Organization
GONZALEZ PHARMACY
Active
Organization
GONZALEZ PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIEL KAISHAR RPH (OWNER PIC)
(626) 221-2103
Entity
Organization
Contact information
Practice address
1240 N HACIENDA BLVD, STE 105, LA PUENTE, CA 91744-1662
(626) 221-2103
(626) 918-4500
Mailing address
1240 N HACIENDA BLVD, STE 105, LA PUENTE, CA 91744-1662
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
PHY48213
CA
3336M0003X
Managed Care Organization Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5625061
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
01/08/2007
Last updated
09/11/2025
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