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General NPI Number Information
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NPI Number | 1356570170
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Entity Type | Organization
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Legal Business Name | DE ANZA VIEW PHARMACY INC
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Dates
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Enumeration Date | 07/14/2009
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Last Update Date | 01/28/2016
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Provider Practice Location Address
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Address Line | 7655 CLAIREMONT MESA BLVD STE 306
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City | SAN DIEGO
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State | CA
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Zip | 92111-1517
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Country | US
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Telephone | 858-268-1660
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Fax | 858-268-1661
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Provider Business Mailing Address
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Address Line | 7655 CLAIREMONT MESA BLVD #306
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City | SAN DIEGO
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State | CA
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Zip | 92111-1512
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Country | US
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Telephone | 858-268-1660
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Fax | 858-268-1661
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Authorized Official
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Title or Position | PRESIDENT AND OWNER
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Name | SHUN KIM
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Credential |
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Telephone | 858-268-1660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 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 #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY53915
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License Number State | CA
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