Provider Demographics
NPI:1356671689
Name:LYNN OAKS COMPOUNDING PHARMACY
Entity Type:Organization
Organization Name:LYNN OAKS COMPOUNDING PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:POON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:805-495-1015
Mailing Address - Street 1:2220 LYNN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-8044
Mailing Address - Country:US
Mailing Address - Phone:805-495-1015
Mailing Address - Fax:805-496-8492
Practice Address - Street 1:2220 LYNN RD STE 100
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-8044
Practice Address - Country:US
Practice Address - Phone:805-495-1015
Practice Address - Fax:805-496-8492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61723333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy