Provider Demographics
NPI:1821349267
Name:CAL OAKS PHARMACY, INC
Entity Type:Organization
Organization Name:CAL OAKS PHARMACY, INC
Other - Org Name:CAL OAKS III HM PHARMACY AT SAN MARINO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MINAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:626-795-5956
Mailing Address - Street 1:55 E CALIFORNIA BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3954
Mailing Address - Country:US
Mailing Address - Phone:626-795-5956
Mailing Address - Fax:626-795-4998
Practice Address - Street 1:2010 HUNTINGTON DR
Practice Address - Street 2:SUITE A
Practice Address - City:SAN MARINO
Practice Address - State:CA
Practice Address - Zip Code:91108-2022
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:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy