Individual
JOHNNY ANTHONY CHAGOLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
26973 NEWPORT RD, MENIFEE, CA 92584
(951) 301-6356
Mailing address
26973 NEWPORT RD, MENIFEE, CA 92584
(951) 301-6356
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
62803
CA
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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