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General NPI Number Information
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NPI Number | 1447440136
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Entity Type | Individual
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Provider Name | BRAD D HEINER PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 07/28/2007
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Last Update Date | 09/20/2013
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Provider Practice Location Address
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Address Line | 4649 MORENA BLVD
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City | SAN DIEGO
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State | CA
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Zip | 92117-3650
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Country | US
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Telephone | 858-812-1353
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Fax |
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Provider Business Mailing Address
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Address Line | 4649 MORENA BLVD
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City | SAN DIEGO
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State | CA
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Zip | 92117-3650
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Country | US
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Telephone | 858-812-1353
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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 | 501088-1701
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 65018
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License Number State | CA
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