Organization
CENTER FOR COMPREHENSIVE CARE & DIAGNOSIS OF INHERITED BLOOD DISOR
Active
Parent organization
THE CENTER FOR COMPREHENSIVE CARE & DIAGNOSIS OF INHERITED BLOOD DISOR
Other names
CIBD Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE CENTER FOR COMPREHENSIVE CARE & DIAGNOSIS OF INHERITED BLOOD DISOR
Authorized official
MARY PHAM PHARM.D, CHC (COO)
(949) 748-7546
Entity
Organization
Contact information
Practice address
18011 SKY PARK CIR, SUITE N, IRVINE, CA 92614-6517
(949) 748-7521
(949) 748-7615
Mailing address
18011 SKY PARK CIR, SUITE N, IRVINE, CA 92614-6517
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
PHY503986
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GI480A
MEDICARE B
CA
Enumeration date
04/01/2013
Last updated
07/16/2019
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