Organization
CDA CLINICAL PHARMACY CORPORATION
Active
Other names
CDA CLINICAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMELIA GRACE PADILLA (CEO/RPH)
(951) 242-2540
Entity
Organization
Contact information
Practice address
11441 HEACOCK ST, STE D, MORENO VALLEY, CA 92557-7907
(951) 242-2540
(951) 242-1490
Mailing address
11441 HEACOCK ST, STE D, MORENO VALLEY, CA 92557-7907
(951) 242-2540
(951) 242-1490
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY 53298
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY53298
CALIFORNIA STATE BOARD OF PHARMACY
CA
Enumeration date
07/22/2015
Last updated
07/28/2015
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