# WADE J DAHLBERG SR

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- **Entity:** Organization
- **Status:** Active
- **Other names:** West Coast Pharmaceutical Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649576364
- **Authorized official:** WILLIAM DAHLBERG (OPERATION MGT)
- **Authorized official phone:** (702) 373-9215

## Contact information

- **Practice address:** 2697 LAVERY CT STE 7, NEWBURY PARK, CA 91320-1587
- **Practice address phone:** (805) 499-0100
- **Practice address fax:** (805) 499-0199
- **Mailing address:** 2697 LAVERY CT STE 7, NEWBURY PARK, CA 91320-1587
- **Mailing address phone:** (805) 499-0100
- **Mailing address fax:** (805) 499-0199

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | PHY50393 | CA | Yes |

## Other

- **Enumeration date:** 01/27/2011
- **Last updated:** 02/07/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5640087 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |