Healthcare Provider Details

I. General information

NPI: 1093597643
Provider Name (Legal Business Name): SALINE LAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 CENTRAL AVE
PEARL HARBOR HI
96860-4908
US

IV. Provider business mailing address

34800 BOB WILSON DR PHARMACY DEPARTMENT
SAN DIEGO CA
92134-1263
US

V. Phone/Fax

Practice location:
  • Phone: 808-473-1880
  • Fax:
Mailing address:
  • Phone: 949-610-3204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number88454
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: