Organization
BELLA VIDA PHARMACY INC
Active
Other names
BELLA VIDA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHEN JING PHARM. D. (PRESIDENT/PIC)
(310) 320-3333
Entity
Organization
Contact information
Practice address
1037 W CARSON ST, TORRANCE, CA 90502-2005
(310) 320-3333
(310) 320-3334
Mailing address
1037 W CARSON ST, TORRANCE, CA 90502-2005
(310) 320-3333
(310) 320-3334
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY 50550
CA
3336C0003X
Community/Retail Pharmacy
Primary
PHY 50550
CA
3336S0011X
Specialty Pharmacy
PHY 50550
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56-27510
NCPDP PROVIDER NUMBER
CA
01
—
PHY50550
RETAIL PHARMACY PERMIT
CA
Enumeration date
07/09/2007
Last updated
07/21/2022
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