Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mactor, Inc

Organization Community/Retail Pharmacy · NPI 1740214790

Mactor, Inc is a Community/Retail Pharmacy in San Diego, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4428 Glacier Ave
San Diego, CA 92120-3304
Phone: (619) 466-3246
Fax: (619) 466-4134
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence 56091 (CA)

Record details

NPI number1740214790
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mitesh Patel — Ceo · (619) 466-3246
Other names Provision Pharmacy
NPI enumeratedJuly 10, 2006
Last updated in NPPESMarch 4, 2020
Certification dateMarch 4, 2020
Mailing address11676 Treadwell Dr, Poway, CA 92064

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