Organization
CAL-MED UNITED DRUGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES WAGNER RPH (PRESIDENT)
(619) 464-8577
Entity
Organization
Contact information
Practice address
5975 SEVERIN DR, LA MESA, CA 91942-3806
(619) 464-8577
(619) 464-8090
Mailing address
5975 SEVERIN DR, LA MESA, CA 91942-3806
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY38149
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0527741
OTHER ID NUMBER
—
05
—
PHA357840
—
CA
Enumeration date
06/23/2006
Last updated
07/03/2008
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