Individual
OU SAEPHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5712 FOLSOM BLVD, SACRAMENTO, CA 95819-4608
(916) 455-6814
Mailing address
5712 FOLSOM BLVD, SACRAMENTO, CA 95819-4608
(916) 455-6814
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
156745
CA
Other
Enumeration date
12/28/2021
Last updated
12/28/2021
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