Organization
MIYADE MEDICAL CENTER PHARMACY
Active
Other names
MEDICAL CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AKIRA MIYADE PHARM D (PRESIDENT)
(310) 338-8885
Entity
Organization
Contact information
Practice address
6801 PARK TER, SUITE 110, LOS ANGELES, CA 90045-1543
(310) 338-8885
(310) 338-8889
Mailing address
6801 PARK TER, SUITE 110, LOS ANGELES, CA 90045-1543
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY43736
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0502117
OTHER ID NUMBER
—
05
—
PHA437360
—
CA
Enumeration date
03/28/2007
Last updated
08/11/2008
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