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General NPI Number Information
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NPI Number | 1023635158
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Entity Type | Individual
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Provider Name | LAUREN RE CLINE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/06/2020
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Last Update Date | 07/06/2020
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Provider Practice Location Address
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Address Line | 10990 SAN DIEGO MISSION RD
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City | SAN DIEGO
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State | CA
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Zip | 92108-2417
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Country | US
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Telephone | 833-574-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 5715 BALTIMORE DR UNIT 109
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City | LA MESA
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State | CA
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Zip | 91942-4252
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 82535
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License Number State | CA
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