| NPI | 1932519550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD COHEN CEO 858-354-9766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2023-12-22 |