Provider Demographics
NPI:1912365958
Name:CHINESE HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:CHINESE HOSPITAL ASSOCIATION
Other - Org Name:CHINESE HOSPITAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:650-761-3560
Mailing Address - Street 1:386 GELLERT BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2611
Mailing Address - Country:US
Mailing Address - Phone:650-761-3560
Mailing Address - Fax:650-761-3582
Practice Address - Street 1:386 GELLERT BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2611
Practice Address - Country:US
Practice Address - Phone:650-761-3560
Practice Address - Fax:650-761-3582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-05
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CA538583336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2157594OtherPK