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Individual

CHARLEMAGNE LACZA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, PHARMD

Contact information

Practice address
2823 FRESNO ST, FRESNO, CA 93721-1324
(559) 459-6000
Mailing address
1362 CARLTON DR, GLENDALE, CA 91205-1421

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
28RI03193300
NJ
183500000X
Pharmacist
49194
TX
183500000X
Pharmacist
Primary
60372
CA

Other

Enumeration date
06/20/2012
Last updated
06/20/2012
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