Organization
HYO SOO LEE
Active
Other names
WILSHIRE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
HYO SOO LEE (OWNER/PRESIDENT)
(213) 483-8025
Entity
Organization
Contact information
Practice address
2013 WILSHIRE BLVD, LOS ANGELES, CA 90057-3503
(213) 483-8025
(213) 483-2640
Mailing address
2013 WILSHIRE BLVD, LOS ANGELES, CA 90057-3503
(213) 483-8025
(213) 483-2640
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY41635
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0543505
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA416350
—
CA
Enumeration date
09/12/2006
Last updated
04/01/2011
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