Organization
CANNON DRUGS
Active
Other names
CANNON DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN LAU (OWNER)
(714) 633-7364
Entity
Organization
Contact information
Practice address
1233 N TUSTIN AVE, ORANGE, CA 92867-5147
(714) 633-7364
(714) 633-1469
Mailing address
1233 N TUSTIN AVE, ORANGE, CA 92867-5147
(714) 633-7364
(714) 633-1469
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY21837
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0573104
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA216370
—
CA
Enumeration date
12/11/2006
Last updated
03/15/2013
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