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General NPI Number Information
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NPI Number | 1902470545
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Entity Type | Individual
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Provider Name | DANIEL STEWART PHARMACY TECHNICIAN
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Gender | Male
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Dates
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Enumeration Date | 05/18/2021
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Last Update Date | 05/18/2021
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Provider Practice Location Address
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Address Line | 4348 BONITA RD
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City | BONITA
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State | CA
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Zip | 91902-1421
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Country | US
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Telephone | 619-267-1617
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Fax | 619-261-1137
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Provider Business Mailing Address
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Address Line | 6359 AVENIDA DE LAS VISTAS UNIT 5
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City | SAN DIEGO
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State | CA
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Zip | 92154-6604
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Country | US
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Telephone | 619-251-1277
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 19976
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License Number State | CA
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