Individual
MUKESH MANSHA AGARWAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 VIOLET ST, COLTON, CA 92324-1603
(909) 809-0567
Mailing address
1501 VIOLET ST, COLTON, CA 92324-1603
(909) 809-0567
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
C168123
CA
Other
Enumeration date
04/13/2021
Last updated
04/14/2021
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