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Individual

MR. GENNADY MAZIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMACY TECH

Contact information

Practice address
7722 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90046-6220
(323) 656-3663
Mailing address
4401 MOORPARK WAY APT 108, TOLUCA LAKE, CA 91602-2471
(818) 508-7266

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
TCH 59900
CA

Other

Enumeration date
05/21/2007
Last updated
07/08/2007
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