| NPI | 1629340609 |
|---|---|
| Doing Business As | PINECREST FAMILY PRACTICE (PINE AVENUE) |
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE VP Of Operations 858-964-1506 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: PA OS005969L) |
| Enumeration Date | 2012-02-06 |
| Last Update Date | 2013-05-23 |