Individual
ASIEH MOGHADDAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6877 SEBASTOPOL AVE, SEBASTOPOL, CA 95472-3416
(707) 823-7209
Mailing address
6877 SEBASTOPOL AVE, SEBASTOPOL, CA 95472-3416
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
62376
CA
Other
Enumeration date
05/17/2019
Last updated
05/17/2019
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