Organization
CSU SAN MARCOS STUDENT HEALTH SRV PHY
Active
Other names
CSU SAN MARCOS SHCS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN NICHOLSON MD (DIRECTOR)
(760) 750-4920
Entity
Organization
Contact information
Practice address
333 S TWIN OAKS VALLEY RD BLDG 21, SAN MARCOS, CA 92096-0001
(760) 750-4021
(760) 750-3181
Mailing address
333 S TWIN OAKS VALLEY RD BLDG 21, SAN MARCOS, CA 92096-0001
(760) 750-4021
(760) 750-3181
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
PHE53294
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1993413
PK
—
Enumeration date
11/28/2006
Last updated
05/20/2015
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