Individual
ANGELICA KRISTINE AGUSTIN LICOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
5600 ORANGETHORPE AVE APT 4401, LA PALMA, CA 90623-1236
(949) 903-8450
Mailing address
5600 ORANGETHORPE AVE APT 4401, LA PALMA, CA 90623-1236
(949) 903-8450
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
80659
CA
Other
Enumeration date
08/24/2019
Last updated
06/24/2021
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