Individual
MRS. ANNIE CHACKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3737 MARTIN LUTHER KING JR BLVD STE 101, LYNWOOD, CA 90262-3525
(310) 537-1440
Mailing address
19221 PIRES AVE, CERRITOS, CA 90703-7354
(562) 865-1837
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
67019
CA
Other
Enumeration date
01/18/2013
Last updated
01/18/2013
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