Organization
61ST MEDICAL SQUADRON SGSR
Active
Other names
LOS ANGELES PHCY 61ST MDS
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR MORALES (CHIEF DHA PASS)
(210) 536-6650
Entity
Organization
Contact information
Practice address
483 N AVIATION BLVD BLDG 210, BLDG 210, EL SEGUNDO, CA 90245-2808
(310) 653-2378
(310) 363-1977
Mailing address
483 N AVIATION BLDG, BLDG 210, EL SEGUNDO, CA 90245-2808
(310) 653-2378
(310) 363-1977
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2066006
PK
—
Enumeration date
09/22/2006
Last updated
06/12/2015
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