Provider Demographics
NPI:1972977783
Name:WWJD PHARMACY CORP
Entity Type:Organization
Organization Name:WWJD PHARMACY CORP
Other - Org Name:TT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO/PHARMACIST IN CHARGE
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM-OANH
Authorized Official - Middle Name:T
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:714-360-8967
Mailing Address - Street 1:9091 EDINGER AVE
Mailing Address - Street 2:STE B
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-7458
Mailing Address - Country:US
Mailing Address - Phone:714-622-5549
Mailing Address - Fax:714-622-5126
Practice Address - Street 1:9091 EDINGER AVE
Practice Address - Street 2:STE B
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-7458
Practice Address - Country:US
Practice Address - Phone:714-622-5549
Practice Address - Fax:714-622-5126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-17
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
CAPHY 537153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4573642Medicaid