Organization
SYCUAN TRIBAL GOVERNMENT
Active
Other names
SYCUAN HEALTH CENTER PHARMACY, SYCUAN MEDICAL DENTAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MAURICE SMITH (EXECUTIVE DIRECTOR)
(619) 445-0707
Entity
Organization
Contact information
Practice address
4921 DEHESA RD, EL CAJON, CA 92019-2929
(619) 445-0707
(619) 445-0901
Mailing address
4921 DEHESA RD, EL CAJON, CA 92019-2929
(619) 445-0707
(619) 445-0901
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHE39873
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2094469
PK
—
Enumeration date
03/09/2007
Last updated
02/13/2026
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