Organization
GARDENA PHARMACY CORPORATION
Active
Other names
GARDENA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LINH M. LE PHARM D (PRESIDENT / PHARMACIST IN CHARGE)
(424) 329-3904
Entity
Organization
Contact information
Practice address
15418 CRENSHAW BLVD, GARDENA, CA 90249-4524
(424) 329-3904
(424) 329-3905
Mailing address
15418 CRENSHAW BLVD, GARDENA, CA 90249-4524
(424) 329-3904
(424) 329-3905
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY 55290
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1664899027
—
CA
01
—
PHY 55290
CALIFORNIA STATE BOARD OF PHARMACY PERMIT
CA
Enumeration date
11/09/2016
Last updated
03/25/2022
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