Provider Demographics
NPI:1689925588
Name:MALUK ENTERPRISING CORPORATION
Entity Type:Organization
Organization Name:MALUK ENTERPRISING CORPORATION
Other - Org Name:ALEX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PIC
Authorized Official - Prefix:MR
Authorized Official - First Name:HUNGTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LUK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:626-571-2290
Mailing Address - Street 1:123 E VALLEY BLVD
Mailing Address - Street 2:#105
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3599
Mailing Address - Country:US
Mailing Address - Phone:626-571-2290
Mailing Address - Fax:626-571-2291
Practice Address - Street 1:123 E VALLEY BLVD
Practice Address - Street 2:#105
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3599
Practice Address - Country:US
Practice Address - Phone:626-571-2290
Practice Address - Fax:626-571-2291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2012-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY 50971333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA56-45657OtherNCPDP NUMBER
CAPHY 50971OtherCALIFORNIA STATE BOARD OF PHARMACY