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| Type | Company | [sources] | |||
|---|---|---|---|---|---|
| Name | Brighton Way Pharmacy dba West Wilshire | [sources] | |||
| Incorporation date | not available | [sources] | |||
| Jurisdiction | not available | [sources] | |||
| Country | United States | [sources] | |||
| NPI | 1487795340 | [sources] | |||
| Registration number | PHA379490 · PHY037949 · PHY37949 · PHY379490 | [sources] | |||
| Sector | Entity/Corporation | [sources] | |||
| Address | 6333 Wilshire Blvd., Los Angeles, CA, 90048 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers suspended from or otherwise deemed ineligible to participate in California's Medicaid program.
United States · DHCS
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