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Individual

RUTH CHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9305 LIGHTWAVE AVE, SAN DIEGO, CA 92123-6463
(619) 543-5399
Mailing address
11179 PROVENCAL PL, SAN DIEGO, CA 92128-3668

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
70137
CA

Other

Enumeration date
11/06/2019
Last updated
11/06/2019
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