Individual
MRS. JACKLIN KOHANSEDGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18254 SHERMAN WAY, RESEDA, CA 91335
(818) 708-7080
(818) 708-9142
Mailing address
5825 RESEDA BLVD, #301, TARZANA, CA 91356
(818) 388-8102
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
TCH30960
CA
Other
Enumeration date
11/02/2006
Last updated
07/08/2007
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