Organization
GONG PHARMACIST PROFESSIONAL CORPORATION
Active
Other names
COMPLETE CARE COMPOUNDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
QIANGSHENG GONG PHARM D (CEO/PIC)
(626) 519-1113
Entity
Organization
Contact information
Practice address
315 S DIAMOND BAR BLVD SUITE D, DIAMOND BAR, CA 91765
(909) 861-6900
(909) 861-6995
Mailing address
315 S DIAMOND BAR BLVD SUITE D, DIAMOND BAR, CA 91765
(909) 861-6900
(909) 861-6995
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
55711
CA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2113495
PK
—
Enumeration date
11/17/2006
Last updated
04/20/2023
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