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General NPI Number Information
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NPI Number | 1336512441
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Entity Type | Organization
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Legal Business Name | FAMILY PHARMACY LLC
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Dates
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Enumeration Date | 11/11/2015
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 31952 DEL OBISPO ST UNIT 240
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-3124
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Country | US
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Telephone | 949-388-9784
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Fax | 949-388-9785
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Provider Business Mailing Address
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Address Line | 31952 DEL OBISPO ST
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-3124
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Country | US
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Telephone | 949-388-9784
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Fax | 949-388-9785
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Authorized Official
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Title or Position | CEO/DIRECTOR
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Name | FATHY ELSAFTY
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Credential |
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Telephone | 832-293-4523
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY55277
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License Number State | CA
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