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General NPI Number Information
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NPI Number | 1376155853
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Entity Type | Individual
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Provider Name | AUSTEN MARIO WERAB PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/17/2020
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Last Update Date | 06/22/2025
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Provider Practice Location Address
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Address Line | 11975 EL CAMINO REAL STE 101
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City | SAN DIEGO
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State | CA
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Zip | 92130-2541
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Country | US
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Telephone | 323-442-1369
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 S HOPE ST APT 1804
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City | LOS ANGELES
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State | CA
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Zip | 90015-4716
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Country | US
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Telephone | 239-249-2608
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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 | RPH90891
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License Number State | CA
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