Provider Demographics
NPI:1437237666
Name:C.K.C. INVESTMENT,INC.
Entity Type:Organization
Organization Name:C.K.C. INVESTMENT,INC.
Other - Org Name:BEN'S VAL MESA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHUN
Authorized Official - Middle Name:KWOK
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:714-992-1234
Mailing Address - Street 1:100 E VALENCIA MESA DR
Mailing Address - Street 2:106
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3813
Mailing Address - Country:US
Mailing Address - Phone:714-992-1234
Mailing Address - Fax:714-992-6668
Practice Address - Street 1:100 E VALENCIA MESA DR
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3813
Practice Address - Country:US
Practice Address - Phone:714-992-1234
Practice Address - Fax:714-992-6668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY 490393336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1437237666Medicaid
CA1437237666Medicaid