Organization
BRAVO PHARMACY LLC
Active
Other names
Bravo Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRED K CHO RPH (MEMBER/PIC)
(323) 586-9828
Entity
Organization
Contact information
Practice address
7316 COMPTON AVE, LOS ANGELES, CA 90001-2532
(323) 586-9828
(323) 589-2174
Mailing address
7316 COMPTON AVE, LOS ANGELES, CA 90001-2532
(323) 586-9828
(323) 589-2174
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY 53315
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912233644
—
CA
01
—
5636343
NCPDP PROVIDER IDENTIFICATION NUMBER
—
01
—
PHY 53315
STATE BOARD OF PHARMACY PERMIT
CA
Enumeration date
10/30/2009
Last updated
05/09/2022
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