Organization
DOMINGUEZ PHARMACY LP
Active
Other names
MEDICAL ARTS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRES DOMINGUEZ PHARM D (GENERAL PARTNER)
(951) 707-5095
Entity
Organization
Contact information
Practice address
1175 E ARROW HWY, UPLAND, CA 91786-5525
(909) 981-1009
(909) 981-3612
Mailing address
949 TALCEY TER, RIVERSIDE, CA 92506-7517
(951) 707-5095
(951) 780-1685
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
49930
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285728683
—
CA
01
—
2120719
PK
—
Enumeration date
10/03/2006
Last updated
07/18/2013
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