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General NPI Number Information
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NPI Number | 1154732998
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Entity Type | Individual
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Provider Name | MR. STEWART EDINGTON
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Gender | Male
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Dates
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Enumeration Date | 05/14/2014
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Last Update Date | 11/06/2018
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Provider Practice Location Address
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Address Line | 23665 MOULTON PKWY STE A
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-1937
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Country | US
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Telephone | 949-586-3664
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Fax |
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Provider Business Mailing Address
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Address Line | 61 VIA CARTAYA
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-6514
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Country | US
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Telephone | 954-818-6813
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS43520
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License Number State | FL
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