Provider Demographics
NPI:1174331284
Name:CALIFORNIA PET PHARMACY
Entity type:Organization
Organization Name:CALIFORNIA PET PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASPREET
Authorized Official - Middle Name:
Authorized Official - Last Name:LALLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-461-4456
Mailing Address - Street 1:3157 CORPORATE PL
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-3915
Mailing Address - Country:US
Mailing Address - Phone:510-785-7736
Mailing Address - Fax:
Practice Address - Street 1:3157 CORPORATE PL
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-3915
Practice Address - Country:US
Practice Address - Phone:510-785-7736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy