MOULTON FAMILY MEDICINE is a non pharmacy dispensing site in Lake Forest, CA. The provider is 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.) MOULTON FAMILY MEDICINE NPI is 1164564712. The provider is registered as an organization entity type.
The provider's business location address is:
22611 LAKE FOREST DR
C-4
LAKE FOREST, CA
ZIP 92630-700
Phone: (949) 951-9399
The provider's authorized official is Kenny Heine .
The authorized official title is Director Of Operations and has the following contact phone number (858) 625-2990.
The enumeration date for this NPI number is 2/12/2007 and was last updated on 10/17/2012.