Moulton Family Medicine
Moulton Family Medicine is a Non-Pharmacy Dispensing Site in Lake Forest, California. Licensed in California. Registered with an NPI since 2007.
- Licensed in
- CA
- In the registry since
- 2007
Practice location Address checks out
22611 Lake Forest Dr C-4Lake Forest, CA 92630-1700
Phone: (949) 951-9399
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Non-Pharmacy Dispensing Site (primary) | Taxonomy 332900000X · Licence A47792 (CA) |
|---|
Record details
| NPI number | 1164564712 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Medvantx, Inc |
| Authorized official | Kenny Heine — Director Of Operations · (858) 625-2990 |
| NPI enumerated | February 12, 2007 |
| Last updated in NPPES | October 17, 2012 |
| Mailing address | 5626 Oberlin Dr, Suite 110, San Diego, CA 92121-1705 |