Organization
PUENTE HILLS PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND WONG PHARM.D. (PHARMACIST)
(626) 912-3311
Entity
Organization
Contact information
Practice address
1850 S AZUSA AVE, SUITE 101, HACIENDA HEIGHTS, CA 91745-6813
(626) 912-3311
Mailing address
1850 S AZUSA AVE, SUITE 101, HACIENDA HEIGHTS, CA 91745-6813
(626) 912-3311
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY35041
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA350410
—
CA
Enumeration date
02/28/2007
Last updated
05/28/2015
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