Provider Demographics
NPI:1700883964
Name:CALIFORNIA PACIFIC PHARMACY INC
Entity Type:Organization
Organization Name:CALIFORNIA PACIFIC PHARMACY INC
Other - Org Name:CALIFORNIA PACIFIC PHCY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LINSK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-489-2672
Mailing Address - Street 1:1000 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-1377
Mailing Address - Country:US
Mailing Address - Phone:213-489-1282
Mailing Address - Fax:213-239-5039
Practice Address - Street 1:1000 W 9TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-1377
Practice Address - Country:US
Practice Address - Phone:213-489-1282
Practice Address - Fax:213-239-5039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-02
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
CAPHY303863336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2002311OtherPK