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Contact Information

STATE OF CALIFORNIA
1250 N BELLFLOWER BLVD
LONG BEACH, CA90840-0004
 Phone: 562-985-1561
 Fax: 562-985-8404
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for STATE OF CALIFORNIA

NPI # 1639190606
LBN Legal business name STATE OF CALIFORNIA
Authorized official KATHY CHEN - (PHARMACY MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/22/2006
Last updated 04/23/2010 - About 16 years ago
Identifiers
CA License # PHE14217
CA Medicaid 142170
Other 0534974 NCPDP PROVIDER IDENTIFICATION NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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