Provider Demographics
NPI:1356092084
Name:LITTLE TOKYO PHARMACY, INC.
Entity Type:Organization
Organization Name:LITTLE TOKYO PHARMACY, INC.
Other - Org Name:LITTLE TOKYO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:213-680-4011
Mailing Address - Street 1:402 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-4209
Mailing Address - Country:US
Mailing Address - Phone:213-680-4011
Mailing Address - Fax:213-680-0307
Practice Address - Street 1:402 E 2ND ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-4209
Practice Address - Country:US
Practice Address - Phone:213-680-4011
Practice Address - Fax:213-680-0307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-14
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy