DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: EVA SUSI MULYAWATI RPH

MEDICARE: EVA SUSI MULYAWATI RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRPH 58064CA

General Provider Information

NPI Number : 1285755751
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVA SUSI MULYAWATI RPH
Provider Business Mailing Address
First Line : 1020 UNIVERSITY AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-7325
Country : US
Telephone Number : 619-298-5181
Fax Number : 619-298-5408
Provider Business Practice Location Address
First Line : 1020 UNIVERSITY AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-7325
Country : US
Telephone Number : 619-298-5181
Fax Number : 619-298-5408
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2007
Last Update Date : 05/07/2026

Similar Medicare Providers

1588263727 — MINJEONG KIM PHARMD
Practice Location Address:
1020 UNIVERSITY AVE
SAN DIEGO, CA
92103-7325
Practice Phone: 619-298-5181
Practice Fax:
1134843022 — PARTH BUTANI
Practice Location Address:
1020 UNIVERSITY AVE
SAN DIEGO, CA
92103-7325
Practice Phone: 619-291-5181
Practice Fax:
1497371082 — MOHAMED NAHSHAL
Practice Location Address:
1020 UNIVERSITY AVE
SAN DIEGO, CA
92103-7325
Practice Phone: 619-298-5181
Practice Fax:
1912922519 — RALPHS GROCERY COMPANY
Practice Location Address:
1020 UNIVERSITY AVE
SAN DIEGO, CA
92103-7325
Practice Phone: 619-298-5181
Practice Fax: 619-298-5408
1497148498 — DR. YOUNG SHIN PHARMD
Practice Location Address:
1020 UNIVERSITY AVE
SAN DIEGO, CA
92103-7325
Practice Phone: 619-298-5181
Practice Fax:
1275972705 — DR. KAITLYN MARIE VOGEL PHARM.D.
Practice Location Address:
3617 OCEAN FRONT WALK APT E
SAN DIEGO, CA
92109-7325
Practice Phone: 858-922-9205
Practice Fax:

Directions to “ EVA SUSI MULYAWATI RPH” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.