# PHYSICIAN SUPPORT SERVICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588915532
- **Authorized official:** RAFA CASTRO (BILLING DEP)
- **Authorized official phone:** (619) 995-0252

## Contact information

- **Practice address:** 8780 19TH ST \# 201, ALTA LOMA, CA 91701-4608
- **Practice address phone:** (619) 995-0252
- **Mailing address:** 8780 19TH ST \# 201, ALTA LOMA, CA 91701-4608

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | CA | Yes |

## Other

- **Enumeration date:** 09/30/2012
- **Last updated:** 09/30/2012