Organization
60TH MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCOS LOPEZ (CLINICAL PHARMACIST)
(707) 423-3459
Entity
Organization
Contact information
Practice address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-3459
Mailing address
2569 SHOREY WAY, FAIRFIELD, CA 94533-6562
(707) 423-6459
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
4679
PR
Other
Enumeration date
09/21/2006
Last updated
06/13/2008
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