Organization
PACIFICA FORTUNA INC
Active
Other names
PACIFICA FORTUNA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALLEN HO (PRESIDENT)
(818) 892-8388
Entity
Organization
Contact information
Practice address
14427 CHASE ST, STE B, PANORAMA CITY, CA 91402-3020
(818) 892-8388
(818) 892-7077
Mailing address
14427 CHASE ST, STE B, PANORAMA CITY, CA 91402-3020
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY46593
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601566
OTHER ID NUMBER
—
05
—
PHA465930
—
CA
Enumeration date
08/10/2006
Last updated
04/30/2008
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