Provider Demographics
NPI:1699136051
Name:SAN LINH LY PHARMACEUTICAL INC
Entity type:Organization
Organization Name:SAN LINH LY PHARMACEUTICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:T
Authorized Official - Last Name:LY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:714-462-1271
Mailing Address - Street 1:10872 FORBES AVE
Mailing Address - Street 2:UNIT B-1
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-6504
Mailing Address - Country:US
Mailing Address - Phone:714-462-1271
Mailing Address - Fax:714-494-1548
Practice Address - Street 1:10872 FORBES AVE
Practice Address - Street 2:UNIT B-1
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-6504
Practice Address - Country:US
Practice Address - Phone:714-462-1271
Practice Address - Fax:714-494-1548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy