Provider Demographics
NPI:1841303542
Name:CAL OASIS CORPOATION
Entity type:Organization
Organization Name:CAL OASIS CORPOATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:LACSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-905-5562
Mailing Address - Street 1:19041 COLIMA RD
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-2922
Mailing Address - Country:US
Mailing Address - Phone:800-905-5562
Mailing Address - Fax:800-971-0772
Practice Address - Street 1:19041 COLIMA RD
Practice Address - Street 2:
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-2922
Practice Address - Country:US
Practice Address - Phone:800-905-5562
Practice Address - Fax:800-971-0772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY475483336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5782380001Medicare NSC