Individual
JERRY S EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
914 TAIT ST.REET, OCEANSIDE, CA 92054
(760) 644-5958
Mailing address
914 TAIT ST.REET, OCEANSIDE, CA 92054
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
32823
CA
1835P1200X
Pharmacotherapy Pharmacist
Primary
6653
OR
Other
Enumeration date
06/27/2011
Last updated
06/27/2011
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