Individual
BONIFACIO G DIMAYACYAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1834 W AVENUE J, LANCASTER, CA 93534-2745
(661) 723-0363
Mailing address
17758 CAPE JASMINE RD, CANYON COUNTRY, CA 91387-3817
(661) 347-3567
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
63837
CA
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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