Individual
SHADEN OMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4077 GOVERNOR DR, SAN DIEGO, CA 92122-2522
(858) 453-0631
Mailing address
4077 GOVERNOR DR, SAN DIEGO, CA 92122-2522
(858) 453-0631
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
176545
CA
Other
Enumeration date
02/15/2022
Last updated
02/15/2022
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