Provider Demographics
NPI:1043505357
Name:SIDAKA'S PHARMACY INC
Entity Type:Organization
Organization Name:SIDAKA'S PHARMACY INC
Other - Org Name:HOPE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / PIC
Authorized Official - Prefix:
Authorized Official - First Name:SIDAKA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-302-3111
Mailing Address - Street 1:31150 TEMECULA PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-2921
Mailing Address - Country:US
Mailing Address - Phone:951-302-3111
Mailing Address - Fax:951-302-3115
Practice Address - Street 1:31150 TEMECULA PKWY STE 100
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-2921
Practice Address - Country:US
Practice Address - Phone:951-302-3111
Practice Address - Fax:951-302-3115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-14
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY559453336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy