SAN DIEGO COMPOUNDING PHARMACY A PROF CORP (NPI# 1508877002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508877002 |
| Entity Type | Organization |
| Organization Name | SAN DIEGO COMPOUNDING PHARMACY A PROF CORP |
| Other Organization Name | SAN DIEGO COMPOUNDING PHARMACY |
| Practice Address |
5395 Ruffin Rd Ste 104 San Diego CA 92123-1338 |
| Practice Telephone | 8582778884 |
| Practice Fax Number | 8582778889 |
| Mailing Telephone | 8582778884 |
| Mailing Fax Number | 8582778889 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2016-08-22 |
| Authorized Official Name | JEROME GREENE (OWNER) |
| Authorized Official Telephone | 8582778884 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY47015 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2113433 | 01 |
| Other Name | Type Code |
|---|---|
| SAN DIEGO COMPOUNDING PHARMACY | Doing Business As Name - Organization |
| Street Address |
5395 RUFFIN RD STE 104 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-1338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
| 1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
| 1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
| 1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
| 1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
| 1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
| 1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
| 1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
| 1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
| 1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
| Find all providers in zip 92123 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689987 | Capsule San Diego LLC | Pharmacy | 1450 Columbia St Ste B, San Diego, CA 92101-3487 | 2020-11-04 |
| 1710520960 | Art Fertility LLC | Pharmacy | 11568 Sorrento Valley Rd Ste 12, San Diego, CA 92121-1313 | 2019-10-21 |
| 1043782022 | Med Specialty Sai Inc | Pharmacy | 4153 University Ave Ste B, San Diego, CA 92105-1421 | 2019-01-01 |
| 1184139834 | Eldahmy Wellness Pharmacy Inc. | Pharmacy | 1985 National Ave Ste 1103, San Diego, CA 92113-2155 | 2017-12-04 |
| 1154835973 | Majestic Pharmacy Inc | Pharmacy | 7283 Engineer Rd Ste D, San Diego, CA 92111-1414 | 2017-12-01 |
| 1730634098 | Med Specialty Sai Inc. | Pharmacy | 4153 University Avenue, Suite B, San Diego, CA 92105 | 2016-08-16 |
| 1043675366 | Tu-uyen Le | Pharmacy | 3081-b Clairemont Drive, San Diego, CA 92117 | 2015-12-31 |
| 1285003442 | Walgreens | Pharmacy | 7937 Hendricks Dr, San Diego, CA 92126-3538 | 2015-09-17 |
| 1376933820 | Walgreen Co | Pharmacy | 602 Euclid Ave, San Diego, CA 92114-2207 | 2015-02-04 |
| 1639567605 | Wellnessrx Pharmacy Corporation | Pharmacy | 5971 University Ave, Suite 304, San Diego, CA 92115-6335 | 2014-12-29 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.