Organization
GRACE WANG
Active
Organization
GRACE WANG
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE WANG RPH (OWNER PHARMACIST)
(805) 375-6650
Entity
Organization
Contact information
Practice address
2241 MICHAEL DR, NEWBURY PARK, CA 91320-3340
(805) 375-6650
(805) 375-6654
Mailing address
2241 MICHAEL DR, NEWBURY PARK, CA 91320-3340
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY41868
CA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0544836
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHY418680
—
CA
Enumeration date
12/26/2006
Last updated
03/07/2023
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