Organization
GOOSE PHARMA, LLC
Active
Other names
One Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY DANG PHARMD. (MANAGER)
(510) 610-1336
Entity
Organization
Contact information
Practice address
18049 MAGNOLIA STREET, FOUNTAIN VALLEY, CA 92708
(510) 610-1336
Mailing address
18049 MAGNOLIA ST, FOUNTAIN VALLEY, CA 92708-5638
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
CA
3336S0011X
Specialty Pharmacy
—
CA
Other
Enumeration date
08/18/2017
Last updated
08/18/2017
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