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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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