Individual
KIMBERLY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6505 MISSION GORGE RD, SAN DIEGO, CA 92120-2306
(619) 284-3345
(619) 284-6549
Mailing address
6505 MISSION GORGE RD, SAN DIEGO, CA 92120-2306
(619) 284-3345
(619) 284-6549
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
TCH25172
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
RITEAID PHARMACY
CA
Enumeration date
11/22/2021
Last updated
11/22/2021
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