| NPI | 1902202120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN HOUGHTALING Pharmacy Supervisor 650-348-1559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 70995) |
| Enumeration Date | 2014-11-16 |
| Last Update Date | 2014-11-16 |