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Organization

MID-WILSHIRE HEALTH INC

Active
Other names
986 pharmacy #8007
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SAMUEL GONG PHARM D (CEO)
(310) 780-0735
Entity
Organization

Contact information

Practice address
1809 VERDUGO BLVD STE 110, GLENDALE, CA 91208-1402
(818) 928-1304
Mailing address
2106 YOSEMITE DR, LOS ANGELES, CA 90041-2702
(310) 780-0735

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary

Other

Enumeration date
09/28/2018
Last updated
09/28/2018
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