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Individual

BRIAN LY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
255 MAIN ST, VENICE, CA 90291-5217
(310) 399-2436
(310) 399-2804
Mailing address
1715 259TH ST UNIT 17, LOMITA, CA 90717-3357

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
76270
CA

Other

Enumeration date
10/27/2017
Last updated
10/27/2017
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