Individual
ABANOB ANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5747 KANAN RD, AGOURA HILLS, CA 91301-1601
(818) 991-5258
(818) 991-3916
Mailing address
5747 KANAN RD, AGOURA HILLS, CA 91301-1601
(818) 991-5258
(818) 991-3916
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
78442
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
78442
RPH LICENSE
CA
Enumeration date
07/06/2018
Last updated
07/06/2018
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