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Organization
PARK MEDICAL PHARMACY
Active
Organization
PARK MEDICAL PHARMACY
Active
Other names
Medical Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE AWAD (OWNER)
(619) 262-4373
Entity
Organization
Contact information
Practice address
855 3RD AVE, STE 1102, CHULA VISTA, CA 91911
(619) 585-0665
(619) 585-0591
Mailing address
610 GATEWAY CENTER WAY, STE A, SAN DIEGO, CA 92102-4533
(619) 585-0665
(619) 585-0591
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PHY 44794
CA
183500000X
Pharmacist
Primary
RPH42751
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA447940
—
CA
01
—
PHY44794
PHARMACY LICENSE
CA
Enumeration date
08/17/2006
Last updated
03/07/2023
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