Individual
ALVIN REYNOLD MORTERA ORALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4707 PACIFIC AVE, T-0313, STOCKTON, CA 95207-6301
(209) 954-9178
Mailing address
4707 PACIFIC AVE, T-0313, STOCKTON, CA 95207-6301
(209) 954-9178
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
63011
CA
Other
Enumeration date
06/15/2011
Last updated
06/15/2011
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