| NPI | 1063524056 |
|---|---|
| Doing Business As | COSTA MESA COMPOUNDING PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MAYANK SHAN President 949-642-0106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: CA PHY48847) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2009-10-01 |