Provider Demographics
NPI:1336128115
Name:HJ ENTERPRISES
Entity Type:Organization
Organization Name:HJ ENTERPRISES
Other - Org Name:CAL OAKS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GEN PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-795-5956
Mailing Address - Street 1:55 E CALIFORNIA BLVD
Mailing Address - Street 2:STE 103
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3914
Mailing Address - Country:US
Mailing Address - Phone:626-795-5956
Mailing Address - Fax:626-795-4998
Practice Address - Street 1:55 E CALIFORNIA BLVD
Practice Address - Street 2:STE 103
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3914
Practice Address - Country:US
Practice Address - Phone:626-795-5956
Practice Address - Fax:626-795-4998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY41874333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
418740OtherMEDICAL
1118770001Medicare ID - Type Unspecified