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Individual

MR. ASHAK FAKOUS BOTROS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM.D

Contact information

Practice address
1021 BRIDGE ST, COLUSA, CA 95932-2839
(530) 458-2494
(858) 412-4306
Mailing address
9245 REGENTS RD UNIT M107, LA JOLLA, CA 92037-9264
(818) 919-9723
(858) 412-4306

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
67020
CA

Other

Enumeration date
07/12/2012
Last updated
07/13/2012
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