Organization
GARRICK SHUM
Active
Other names
FISHERS BREA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GARRICK SHUM (OWNER)
(714) 925-2622
Entity
Organization
Contact information
Practice address
385 W CENTRAL AVE, STE E, BREA, CA 92821-3000
(714) 529-2113
(714) 529-5614
Mailing address
385 W CENTRAL AVE, STE E, BREA, CA 92821-3000
(714) 529-2113
(714) 529-5614
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY48760
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0505632
OTHER ID NUMBER
—
05
—
PHA454610
—
CA
Enumeration date
01/08/2007
Last updated
08/18/2010
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