| NPI | 1841685971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BIRGER GREG BACINO Owner 858-525-5744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2015-07-23 |