NPI: 1902944648 · BUENA PARK, CA 90621 · Community/Retail Pharmacy · NPI assigned 02/02/2007
| Authorized Official | PAE, YON-KYONG (PRESIDENT) |
| NPI Enumeration Date | 02/02/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 13 | $134.79 |
| 2021 | 14 | $91.53 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A4253 | Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips | 27 | 27 | $226.32 |