Organization
IMPERIAL BEACH PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRASHANT AMRUTLAL KOYANI PHARMD (MEMBER)
(619) 343-0095
Entity
Organization
Contact information
Practice address
1530 PALM AVE, SAN DIEGO, CA 92154-1016
(619) 343-0095
(619) 830-4590
Mailing address
1530 PALM AVE, SAN DIEGO, CA 92154-1016
(619) 343-0095
(619) 830-4590
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
09/06/2020
Last updated
02/08/2024
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