Individual
MORRELL JEROME LAVENDER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-7560
Mailing address
1705 CROSSROADS ST, CHULA VISTA, CA 91915-1840
(619) 415-1203
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
81495
CA
Other
Enumeration date
01/31/2010
Last updated
03/14/2014
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