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General NPI Number Information
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NPI Number | 1336146935
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Entity Type | Organization
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Legal Business Name | DREYFUS ENTERPRISES
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 08/22/2020
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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 | 949-768-5700
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Fax | 949-768-1359
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Provider Business Mailing 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 | 949-768-5700
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Fax | 949-768-1359
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARY A DREYFUS
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Credential |
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Telephone | 949-768-5700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 819437
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License Number State | CA
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