Organization
WATTS CLINIC PHARMACY
Active
Other names
Pharmedquest Pharmacy Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DALILA IBARRA (LICENSING & CREDENTIALING COORDINAT)
(714) 599-8181
Entity
Organization
Contact information
Practice address
10300 COMPTON AVE, LOS ANGELES, CA 90002-3628
(714) 926-7131
Mailing address
10604 COURSEY BLVD, BATON ROUGE, LA 70816-4015
(714) 599-8181
(714) 599-8242
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
PHY46869
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5615591
NCPDP NUMBER
CA
05
—
PHA463330
—
CA
01
—
PHY46869
STATE LICENSE
CA
Enumeration date
01/31/2007
Last updated
02/27/2023
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