Organization
KNOLLS PHARMACY
Active
Other names
Gordon Wong
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GORDON WONG PHARMD (OWNER PHARMACIST)
(310) 454-6000
Entity
Organization
Contact information
Practice address
16630 MARQUEZ AVE, PACIFIC PALISADES, CA 90272-3233
(310) 454-6000
(310) 454-0605
Mailing address
16630 MARQUEZ AVE, PACIFIC PALISADES, CA 90272-3233
(310) 454-6000
(310) 454-0605
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY36924
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1994466
PK
—
Enumeration date
03/05/2007
Last updated
11/17/2017
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