Organization
LC SAN DIEGO LLC
Active
Other names
Palomar Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
VERA ABRAMOVA (CFO)
(516) 422-8477
Entity
Organization
Contact information
Practice address
1955 CITRACADO PKWY, STE 101, ESCONDIDO, CA 92029-4110
(760) 294-0790
(760) 294-0791
Mailing address
1955 CITRACADO PKWY, STE 101, ESCONDIDO, CA 92029-4110
(760) 294-0790
(760) 294-0791
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY55614
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730432469
—
CA
01
—
2168780
PK
—
Enumeration date
10/18/2012
Last updated
07/19/2018
About Stedi
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