Individual
JACQUELINE PAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1031 XIMENO AVE, LONG BEACH, CA 90804-4304
(561) 760-5204
Mailing address
1031 XIMENO AVE, LONG BEACH, CA 90804-4304
(562) 760-5204
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
79584
CA
Other
Enumeration date
01/11/2024
Last updated
01/11/2024
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