Organization
CHULAVISTA PHARMACY LLC
Active
Other names
CHULAVISTA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELVIS ATENCIO PHARMD (PHARMACIST/PARTNER)
(619) 781-8177
Entity
Organization
Contact information
Practice address
384 H ST, CHULA VISTA, CA 91910-5513
(619) 781-8177
(619) 623-3435
Mailing address
384 H ST, CHULA VISTA, CA 91910-5513
(619) 781-8177
(619) 623-3435
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY55409
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05-79435
NCPDP NUMBER
CA
01
—
1942200902
MEDI-CAL PROVIDER
CA
01
—
2004678
PK
—
01
—
PHY55409
CA BOARD OF PHARMACY PERMIT
CA
Enumeration date
07/29/2005
Last updated
07/21/2025
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