Organization
ALVARADO MEDICAL PLAZA PHARMACY
Active
Other names
Alvarado Medical Plaza Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BILL BURDINE BS (OWNER)
(619) 287-5035
Entity
Organization
Contact information
Practice address
5555 RESERVOIR DR STE 114, SAN DIEGO, CA 92120-5197
(619) 287-5035
(619) 287-5098
Mailing address
5555 RESERVOIR DR STE 114, SAN DIEGO, CA 92120-5197
(619) 287-5035
(619) 287-5098
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY38199
CA
3336C0004X
Compounding Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2115610
PK
—
05
—
PHA3204424
—
CA
Enumeration date
05/20/2006
Last updated
12/17/2015
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