Organization
CUSTOM HEALTHCARE COMPOUNDING PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANHVUONG LY (PHARMACIST IN CHARGE)
(925) 330-8975
Entity
Organization
Contact information
Practice address
24022 CALLE DE LA PLATA STE 510, LAGUNA HILLS, CA 92653-3631
(949) 595-2273
(949) 595-2275
Mailing address
24022 CALLE DE LA PLATA STE 510, LAGUNA HILLS, CA 92653-3631
(949) 595-2273
(949) 595-2275
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
51905
CA
Other
Enumeration date
03/27/2013
Last updated
09/28/2015
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