Organization · Type 2 NPI
Moulton Family Medicine
Non-Pharmacy Dispensing Site · Lake Forest, CA
NPI number
1164564712
Active
Practice location
22611 Lake Forest Dr, C-4
Lake Forest, CA 92630-1700
Mailing address
5626 Oberlin Dr, Suite 110
San Diego, CA 92121-1705
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Non-Pharmacy Dispensing Site Primary | 332900000X | A47792 (CA) |
Non-Pharmacy Dispensing Site: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
3 other providers at this address
About NPI 1164564712
Moulton Family Medicine's National Provider Identifier is 1164564712, issued on Feb 12, 2007. The primary taxonomy on file is Non-Pharmacy Dispensing Site (332900000X), and the practice location is in Lake Forest, CA. The record was last updated on Oct 17, 2012.