Organization
HESPERIA LA SALLE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YOUNG S KIM (OWNER RPH)
(760) 956-2270
Entity
Organization
Contact information
Practice address
16455 MAIN ST, #8, HESPERIA, CA 92345
(760) 956-2270
(760) 956-7093
Mailing address
16455 MAIN ST, #8, HESPERIA, CA 92345
(760) 956-2270
(760) 956-7093
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY 43984
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA439850
—
CA
Enumeration date
12/13/2006
Last updated
08/31/2010
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