Organization
SETON MEDICAL CENTER COATSIDE
Active
Other names
SETON MEDICAL CENTER COASTSIDE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARTHA E YASAVOLIAN PHARM.D. (DIRECTOR OF PHARMACY)
(650) 991-6488
Entity
Organization
Contact information
Practice address
600 MARINE BLVD, MOSS BEACH, CA 94038-9641
(650) 991-6488
(650) 991-6683
Mailing address
1900 SULLIVAN AVE, DALY CITY, CA 94015-2229
(650) 991-6488
(650) 991-6683
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
HSP45702
CA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0555877
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/03/2006
Last updated
07/13/2010
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