Individual
FANUEL GHEBREMICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
968 VILLAGE CIR, OAKLAND, CA 94607-3151
(510) 422-9367
Mailing address
968 VILLAGE CIR, OAKLAND, CA 94607-3151
(510) 422-9367
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
CA
Other
Enumeration date
10/02/2020
Last updated
10/02/2020
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