Organization
JOSE R SARDINAS
Active
Other names
Plaza Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE R SARDINAS PHARMACIST (OWNER/PHARMACIST)
(310) 973-5200
Entity
Organization
Contact information
Practice address
11930 HAWTHORNE BLVD, HAWTHORNE, CA 90250-3016
(310) 973-5200
Mailing address
11930 HAWTHORNE BLV, HAWTHORNE, CA 90250
(310) 973-5200
(310) 973-1243
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY20259
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0566589
TAX 028418
—
01
—
PHA202590
MEDICAL
—
Enumeration date
02/26/2007
Last updated
08/06/2008
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