Individual
ABDULLATIF ALJASIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11925 BARCLAY DR, MORENO VALLEY, CA 92557-5915
(415) 936-4567
Mailing address
11925 BARCLAY DR, MORENO VALLEY, CA 92557-5915
(415) 936-4567
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
Y4777315
CA
Other
Enumeration date
03/22/2019
Last updated
03/22/2019
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