Organization
BONITA PHARMACY INC
Active
Other names
BONITA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK YEP RPH (OWNER/PHARMACIST IN CHRG)
(619) 475-4112
Entity
Organization
Contact information
Practice address
4190 BONITA RD, STE 101, BONITA, CA 91902-1329
(619) 475-4112
(619) 475-4113
Mailing address
4190 BONITA RD, STE 101, BONITA, CA 91902-1329
(619) 475-4112
(619) 475-4113
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY21603
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0529428
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA216030
—
CA
Enumeration date
09/20/2006
Last updated
09/04/2009
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