Healthcare Provider Details

I. General information

NPI: 1275835332
Provider Name (Legal Business Name): FELICITA PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2010
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 W CITRACADO PKWY STE 106
ESCONDIDO CA
92025-6428
US

IV. Provider business mailing address

625 W CITRACADO PKWY STE 106
ESCONDIDO CA
92025-6428
US

V. Phone/Fax

Practice location:
  • Phone: 760-432-8520
  • Fax: 760-432-8585
Mailing address:
  • Phone: 760-432-8520
  • Fax: 760-432-8585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number50423
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. GISOO SAMANDARI
Title or Position: CEO
Credential: BS
Phone: 760-201-7529