| NPI | 1205978988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT PETERSON CFO 858-625-2990 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: PA MD020402E) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2016-11-08 |