Organization
AIR FORCE
Active
Other names
David Grant Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARCOS J LOPEZ (CLINICAL PHARMACIST)
(707) 423-3459
Entity
Organization
Contact information
Practice address
2569 SHOREY WAY, FAIRFIELD, CA 94533-6562
(707) 816-8622
Mailing address
2569 SHOREY WAY, FAIRFIELD, CA 94533-6562
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
4679
PR
Other
Enumeration date
12/14/2006
Last updated
08/22/2020
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