| NPI | 1497814594 |
|---|---|
| Doing Business As | CREEKSIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | TONY IBRAHIM CEO 760-987-6796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY55615) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2024-11-08 |