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General NPI Number Information
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NPI Number | 1376318345
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Entity Type | Organization
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Legal Business Name | ALVARADO PHARMACY SD
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 03/20/2024
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Provider Practice Location Address
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Address Line | 5555 RESERVOIR DR STE 114
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City | SAN DIEGO
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State | CA
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Zip | 92120-5197
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Country | US
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Telephone | 619-996-0619
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Fax | 619-877-0110
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Provider Business Mailing Address
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Address Line | 5555 RESERVOIR DR STE 114
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City | SAN DIEGO
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State | CA
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Zip | 92120-5197
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Country | US
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Telephone | 619-996-0619
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Fax | 619-877-0110
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE/OWNER
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Name | CRYSTAL NAOUM
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Credential | PHARMD
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Telephone | 504-402-7033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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