Provider Demographics
NPI:1336437953
Name:AJL CONSULTING
Entity Type:Organization
Organization Name:AJL CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:LANCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-449-9153
Mailing Address - Street 1:PO BOX 712212
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92072-2212
Mailing Address - Country:US
Mailing Address - Phone:619-449-9153
Mailing Address - Fax:
Practice Address - Street 1:10408 ESCADERA DR
Practice Address - Street 2:
Practice Address - City:LAKESIDE
Practice Address - State:CA
Practice Address - Zip Code:92040-2226
Practice Address - Country:US
Practice Address - Phone:619-449-9153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-17
Last Update Date:2011-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 291581835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatricGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARPH 29158OtherRPH LICENSE #RPH29158