Organization
MESA PHARMACY INC
Active
Other names
MESA PHARMACY VI
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW MINH (PRESIDENT)
(702) 354-7578
Entity
Organization
Contact information
Practice address
1900 ROYALTY DR, STE 190, POMONA, CA 91767-3032
(909) 623-8600
(909) 623-8686
Mailing address
18013 SKY PARK CIR, STE D, IRVINE, CA 92614-6518
(949) 955-2975
(949) 955-2925
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY48992
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5630339
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/08/2008
Last updated
06/22/2010
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