Organization
ILLUMINATE HEALTH INC
Active
Other names
Illuminate Health Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LILIA XU PHARM.D. (CEO)
(626) 522-1013
Entity
Organization
Contact information
Practice address
3948 PECK RD UNIT A9, EL MONTE, CA 91732-2255
(626) 522-1013
Mailing address
3948 PECK RD UNIT A9, EL MONTE, CA 91732-2255
(626) 522-1013
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58704
PHARMACY LICENSE
CA
Enumeration date
05/11/2017
Last updated
06/21/2022
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