Provider Demographics
NPI:1235590555
Name:SANTA ANA PHARMACY HEALTH CENTER
Entity Type:Organization
Organization Name:SANTA ANA PHARMACY HEALTH CENTER
Other - Org Name:SANTA ANA PHARMACY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUONG
Authorized Official - Middle Name:K
Authorized Official - Last Name:DOAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-804-6855
Mailing Address - Street 1:1103 S HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-2347
Mailing Address - Country:US
Mailing Address - Phone:714-804-6855
Mailing Address - Fax:626-442-2066
Practice Address - Street 1:1103 S HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-2347
Practice Address - Country:US
Practice Address - Phone:714-804-6855
Practice Address - Fax:626-442-2066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy