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Moulton Family Medicine
Non-Pharmacy Dispensing Site in Lake Forest, California
NPI 1164564712

Moulton Family Medicine is a Non-Pharmacy Dispensing Site based in San Diego, CA. Moulton Family Medicine practices in Lake Forest, CA. The NPI Number for Moulton Family Medicine is 1164564712 and holds a License No. A47792 (California).

The current practice location address for Moulton Family Medicine is 22611 Lake Forest Dr, Lake Forest, CA and can be reached out via phone at 949-951-9399.

Location: 22611 Lake Forest Dr, Lake Forest, CA, 92121-1705
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1164564712
Provider Name
Moulton Family Medicine
Credential
Provider Entity Type
Organization
Address
22611 Lake Forest Dr, Lake Forest, CA, 92121-1705
Phone Number
949-951-9399
Fax Number
Provider Enumeration Date
02/12/2007
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
22611 Lake Forest Dr
City
Lake Forest
State
California
Zip
92630-1700
Phone Number
949-951-9399
Fax Number
person
Provider Business Mailing Address Details
Address
22611 Lake Forest Dr
City
Lake Forest
State
California
Zip
92630-1700
Phone Number
949-951-9399
Fax Number
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Non-Pharmacy Dispensing Site
Speciality
-
Taxonomy
332900000X
License No.
A47792 (California)
Definition
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.)
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