Organization
LOS ANGELES CHRISTIAN HEALTH CENTERS
Active
Other names
Pico Aliso Community Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BETTINA LEWIS (COO)
(213) 893-1960
Entity
Organization
Contact information
Practice address
1625 E 4TH ST, LOS ANGELES, CA 90033-4201
(323) 268-8391
(858) 633-4702
Mailing address
1625 E 4TH ST, LOS ANGELES, CA 90033-4201
(323) 268-8391
(858) 633-4702
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY49915
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770855132
—
CA
01
—
2134659
PK
—
Enumeration date
02/01/2012
Last updated
05/07/2021
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