SOUTHERN CALIFORNIA COMPOUNDING PHARMACY NPI 1669617734

NPI Information

  • NPI: 1669617734
  • Provider Name: SOUTHERN CALIFORNIA COMPOUNDING PHARMACY
  • Classification: Pharmacy - 3336C0004X
  • Specialization: Compounding Pharmacy
  • Entity Type: Organization
  • Doing Business As: SOUTHERN CALIFORNIA COMPOUNDING PHARMACY
  • Address: 11125 FLINTKOTE AVE STE F
    SAN DIEGO, CA
    ZIP 92121
  • Phone: (858) 622-1278

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NPI Details

SOUTHERN CALIFORNIA COMPOUNDING PHARMACY is a compounding pharmacy pharmacy in San Diego, CA. The provider is a pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. SOUTHERN CALIFORNIA COMPOUNDING PHARMACY NPI is 1669617734. The provider is registered as an organization entity type.
The provider Is Doing Business As Southern California Compounding Pharmacy.

The provider's business location address is:

11125 FLINTKOTE AVE STE F
SAN DIEGO, CA
ZIP 92121-213
Phone: (858) 622-1278
Fax: (858) 622-1283

The provider's authorized official is Ollen Williams .
The authorized official title is Technician and has the following contact phone number (858) 622-1278.

The enumeration date for this NPI number is 12/3/2008 and was last updated on 10/23/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
33336M0002XPharmacyMail Order PharmacyNo
43336S0011XPharmacySpecialty PharmacyNo
53336C0004XPharmacyCompounding PharmacyPHY49147CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12117954OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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