Portola Pharmacy
LBN: Compounding Pharmacy Associates And Consultants Inc
Portola Pharmacy is an health care organization with primary practice located at 3408 N Eastern Ave , Los Angeles CA 90032-1934. The organization recently has 3 registered licenses in different health care specialties including Laboratories / Clinical Medical Laboratory, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Compounding Pharmacy Associates And Consultants Inc can be contacted via phone (323) 222-2362, or through Chen, Geneva Ge via phone (323) 222-2362.
Contact Information
Primary practice address
3408 N Eastern Ave
Los Angeles CA 90032-1934
Phone: (323) 222-2362
Fax: (323) 225-4171
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Laboratories / Clinical Medical Laboratory | 291U00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PHY55260 | California |
Profile Details
| NPI number | 1275669020 |
|---|---|
| LBN Legal business name | Compounding Pharmacy Associates And Consultants Inc |
| DBA Doing business as | Portola Pharmacy |
| Authorized official | Chen, Geneva Ge PHARM D PHD |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 26th, 2007 |
| Last updated | Mar 11th, 2021 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275669020 | NPPES |
| California | MEDICAID | 1275669020 | |
| California | Other | PHY55260 | |
| California | Other | 05-10760 |
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