Individual
ADAM KANDIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3960 BROAD ST, SAN LUIS OBISPO, CA 93401-7018
(805) 783-2903
Mailing address
1534 BRIGHTON AVE APT 17, GROVER BEACH, CA 93433-1868
(805) 305-6565
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
35267
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1234567
1234567
CA
Enumeration date
05/14/2019
Last updated
05/14/2019
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