NPI: 1225661796 · ANAHEIM, CA 92805 · Community/Retail Pharmacy · NPI assigned 02/12/2020
| Authorized Official | TA, BRANDY (SECRETARY/ PIC) |
| NPI Enumeration Date | 02/12/2020 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 73 | $17K |
| Code | Description | Claims | Bene. Records | Total Paid |
|---|---|---|---|---|
| J3490 | Unclassified drugs | 73 | 67 | $17K |