Individual
AMANDA FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(619) 543-6222
Mailing address
4647 IDAHO ST UNIT 1, SAN DIEGO, CA 92116-3161
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
86129
CA
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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