Organization
KNIGHTS JXL PHARMACY INC
Active
Other names
ICON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JIAJUN XUE (PRESIDENT/CEO)
(949) 909-0029
Entity
Organization
Contact information
Practice address
23141 MOULTON PKWY STE 104, LAGUNA HILLS, CA 92653-1241
(949) 909-0029
(949) 991-3428
Mailing address
23141 MOULTON PKWY STE 104, LAGUNA HILLS, CA 92653-1241
(949) 909-0029
(949) 991-3428
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY61540
BOP
CA
Enumeration date
05/14/2026
Last updated
05/14/2026
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