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General NPI Number Information
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NPI Number | 1881014074
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Entity Type | Individual
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Provider Name | STAN BARTH
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Gender | Male
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Dates
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Enumeration Date | 04/26/2014
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Last Update Date | 04/26/2014
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Provider Practice Location Address
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Address Line | 17030 BUTTERFIELD TRL
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City | POWAY
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State | CA
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Zip | 92064-1344
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Country | US
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Telephone | 858-602-7555
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Fax | 858-451-9439
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Provider Business Mailing Address
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Address Line | 17030 BUTTERFIELD TRL
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City | POWAY
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State | CA
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Zip | 92064-1344
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Country | US
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Telephone | 858-602-7555
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Fax | 858-451-9439
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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 | 35850
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License Number State | CA
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