Registry details
Type
Individual
Primary specialty
Pharmacist
Enumerated
Jul 19, 2010
License(s)
40955 (CA), 40955 (CO)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 22371 RIDGEBROOK | Mission Viejo, CA 92692-4529 | 949-595-0272 |
| LOCATION | 30222 CROWN VALLEY PKWY | Laguna Niguel, CA 92677-2332 | 949-495-5823 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.