SOUTHERN CALIFORNIA COMPOUNDING PHARMACY (NPI# 1669617734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669617734 |
| Entity Type | Organization |
| Organization Name | SOUTHERN CALIFORNIA COMPOUNDING PHARMACY |
| Other Organization Name | SOUTHERN CALIFORNIA COMPOUNDING PHARMACY |
| Practice Address |
11125 Flintkote Ave Ste F San Diego CA 92121-1213 |
| Practice Telephone | 8586221278 |
| Practice Fax Number | 8586221283 |
| Mailing Telephone | 8586221278 |
| Mailing Fax Number | 8586221283 |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2015-10-23 |
| Authorized Official Name | OLLEN WILLIAMS (TECHNICIAN) |
| Authorized Official Telephone | 8586221278 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 3336M0002X |
Pharmacy Specialization: Mail Order Pharmacy |
Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
PHY49147 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2117954 | 01 |
| Other Name | Type Code |
|---|---|
| Southern California Compounding Pharmacy | Doing Business As Name - Organization |
| Street Address |
11125 FLINTKOTE AVE STE F |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92121-1213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644917 | Anna Hand | Physical Therapist | 5945 Pacific Center Blvd Bldg #510, San Diego, CA 92121 | 2020-09-18 |
| 1972138030 | Lamarr Joyner | Licensed Vocational Nurse | 5930 Conerstone Court West, Suite 300, San Diego, CA 92121 | 2020-03-10 |
| 1396383212 | La Jolla Professional Plastic Surgery | Plastic Surgery | 4510 Executive Dr. Suite 105, San Diego, CA 92121 | 2019-12-11 |
| 1841852472 | Unmanned Systems Operations Group | Air Carrier | 4655 Executive Dr., Suite 700, San Diego, CA 92121 | 2019-07-03 |
| 1861051922 | Grace Getchell | Behavior Technician | 3978 Sorrento Valley Blvd. #100, San Diego, CA 92121 | 2019-06-11 |
| 1720643299 | Megan Jean Bathen | Behavior Technician | Cortica Behavioral Inc., 7090 Miratech Dr., San Diego, CA 92121 | 2019-05-09 |
| 1346804366 | Daniel Melita | Massage Therapist | 11689 Sorrento Valley Rd Ste Q, San Diego, CA 92121 | 2019-04-25 |
| 1831674464 | Stepahnie Becerra | Behavior Technician | 3978 Sorrento Valley Blvd Suite 100, San Diego, CA 92121 | 2018-09-28 |
| 1265915466 | Ailyn Martinez | Behavior Technician | 3978 Sorrento Valley Bldv, 100, San Diego, CA 92121 | 2018-09-13 |
| 1790265163 | Genben Lifesciences Corporation | Public Health or Welfare | 6370 Lusk Blvd Ste F205, San Diego, CA 92121 | 2018-08-15 |
| Find all providers in zip 92121 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639688732 | Cure Stat Rx Home Infusion and Specialty Pharmacy Inc | Pharmacy | 6725 Mesa Ridge Rd Ste 202&230, San Diego, CA 92121-2923 | 2017-09-21 |
| 1205008299 | Snp Pharmacy LLC | Pharmacy | 9920 Scripps Lake Dr, Ste 108, San Diego, CA 92131-1080 | 2008-03-31 |
| 1659436079 | Mikmara Inc | Pharmacy | 1141 6th Ave, San Diego, CA 92101-5203 | 2006-12-26 |
| 1841395761 | Mission Pharmacy & Compounding, Ltd | Pharmacy | 6020 Santo Rd, Suite B, San Diego, CA 92124-1195 | 2006-09-14 |
| 1306854385 | St Marys Pharmacies Inc | Pharmacy | 610 Gateway Center Way, Ste A, San Diego, CA 92102-4533 | 2006-08-04 |
| 1609437409 | Remedy Holistic Pharmacy LLC | Pharmacy | 320 W Cedar St Ste 103, San Diego, CA 92101-2908 | 2019-06-24 |
| 1891228367 | Alvarado Pharmacy Services, Inc | Pharmacy | 5555 Reservoir Dr Ste 114, San Diego, CA 92120-5197 | 2017-04-11 |
| 1902268220 | Guardian Pharmacy of Southern California LLC | Pharmacy | 10140 Barnes Canyon Rd, San Diego, CA 92121-2724 | 2016-03-25 |
| 1841685971 | Fblt Management LLC | Pharmacy | 5755 Oberlin Dr Ste 301, San Diego, CA 92121-4717 | 2015-04-06 |
| 1275954224 | Irx Pharmacy South Inc. | Pharmacy | 12750 Carmel Country Rd, Ste A101, San Diego, CA 92130-2159 | 2013-12-18 |
| 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.