Individual
DAISY MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
160 DIAMOND DR, LAKE ELSINORE, CA 92530-4401
(949) 326-6919
Mailing address
160 DIAMOND DR, LAKE ELSINORE, CA 92530-4401
(949) 326-6919
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
TCH193331
CA
Other
Enumeration date
07/19/2023
Last updated
07/19/2023
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