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Organization
VISTA DRUG
Active
Organization
VISTA DRUG
Active
Other names
vista drug
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GILBERT BUDHU (OWNER)
(949) 642-4500
Entity
Organization
Contact information
Practice address
821 W 19TH ST, COSTA MESA, CA 92627-3518
(949) 642-4500
Mailing address
821 W 19TH ST, COSTA MESA, CA 92627-3518
(949) 642-4500
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0588787
NABP
CA
01
—
PHY339360
PHARMACY LIC #
CA
Enumeration date
10/29/2006
Last updated
11/22/2024
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