Provider Demographics
NPI:1548576317
Name:CREATIVE COMPOUNDS INC
Entity type:Organization
Organization Name:CREATIVE COMPOUNDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:949-642-0106
Mailing Address - Street 1:3500 W LAKE CENTER DR STE B
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6900
Mailing Address - Country:US
Mailing Address - Phone:949-642-0106
Mailing Address - Fax:949-642-5039
Practice Address - Street 1:3500 W LAKE CENTER DR STE B
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6900
Practice Address - Country:US
Practice Address - Phone:949-642-0106
Practice Address - Fax:949-642-5039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-31
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY59500OtherRETAIL PHARMACY PERMIT
CAPHY50397OtherRETAIL PHARMACY PERMIT