Individual
CHIEN ORIGINALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
31960 TEAL CT, YUCAIPA, CA 92399-7205
(909) 919-4837
Mailing address
31960 TEAL CT, YUCAIPA, CA 92399-7205
(909) 910-4837
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
84140
CA
Other
Enumeration date
12/16/2021
Last updated
12/16/2021
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