Southern California Compounding Pharmacy
NPI 1669617734ActiveOrganization· Pharmacy, Compounding Pharmacy· San Diego, CA
Pharmacy, Compounding Pharmacy in San Diego, California, registered in NPPES in December 2008. The authorized official on file is Ollen Williams, Technician.
Overview
| NPI | 1669617734 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 3, 2008 |
| Last updated in NPPES | Oct 23, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy, Compounding Pharmacy Primary | 3336C0004X | PHY49147 | CA |
| Pharmacy | 333600000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — | — |
| Pharmacy, Mail Order Pharmacy | 3336M0002X | — | — |
| Pharmacy, Specialty Pharmacy | 3336S0011X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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