MEDICARE: MARK JOHN BADRIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	41678	CA

General Provider Information

NPI Number	:	1861351611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK JOHN BADRIA

Provider Business Mailing Address
First Line	:	4648 MARLBOROUGH DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92116-4711
Country	:	US
Telephone Number	:	415-370-3984
Fax Number	:	415-370-3984

Provider Business Practice Location Address
First Line	:	4648 MARLBOROUGH DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92116-4711
Country	:	US
Telephone Number	:	415-370-3984
Fax Number	:	415-370-3984

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “ MARK JOHN BADRIA ” Practice Location

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