Organization
PROVISION PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN CHAN PHARM.D (CEO)
(808) 854-8999
Entity
Organization
Contact information
Practice address
4428 GLACIER AVE, SAN DIEGO, CA 92120-3304
(808) 854-8999
Mailing address
4428 GLACIER AVE, SAN DIEGO, CA 92120-3304
(808) 854-8999
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
12/11/2025
Last updated
12/11/2025
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