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Individual

CAVA GENEVIEVE HADIKUSUMO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARM.D.

Contact information

Practice address
9310 SIERRA AVE, FONTANA, CA 92335-5711
(909) 427-3838
(909) 427-3830
Mailing address
9310 SIERRA AVE, FONTANA, CA 92335-5711

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH 57282
CA

Other

Enumeration date
11/15/2006
Last updated
07/08/2007
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