Organization
KS HEALTHCARE
Active
Other names
986 Pharmacy #8025
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN GONG PHARM D. (CEO)
(310) 780-7470
Entity
Organization
Contact information
Practice address
904 E PACIFIC COAST HIGHWAY, LONG BEACH, CA 90806-5626
(562) 436-7257
(562) 436-8998
Mailing address
904 E PACIFIC COAST HIGHWAY, LONG BEACH, CA 90806-5626
(562) 436-7257
(562) 436-8998
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY59612
BOARD OF PHARMACY
CA
Enumeration date
05/22/2019
Last updated
08/14/2024
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