Organization
BOTICA EL MONTE
Active
Organization
BOTICA EL MONTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK ONGGOSUWARNO (OWNER)
(626) 579-6277
Entity
Organization
Contact information
Practice address
10808 RAMONA BLVD, EL MONTE, CA 91731-2628
(626) 579-6277
(626) 579-6739
Mailing address
10808 RAMONA BLVD, EL MONTE, CA 91731-2628
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY43221
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0537386
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA432210
—
CA
Enumeration date
08/10/2006
Last updated
02/08/2008
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