Individual
MS. ANNAMMA SUMI MAMMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3320 N TRACY BLVD, TRACY, CA 95376-1796
(209) 836-2316
Mailing address
3320 NORTH TRACY BLVD, CALIFORNIA .US.95376, TRACY, CA 95376
(209) 836-2316
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
84470
CA
Other
Enumeration date
11/29/2021
Last updated
11/29/2021
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