Individual
MS. AGUSTINA JULIA TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12254 BELLFLOWER BLVD, DOWNEY, CA 90242-2804
(562) 658-3627
Mailing address
2015 W KENNETH RD, GLENDALE, CA 91201-1115
(818) 562-1954
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
38274
CA
Other
Enumeration date
01/28/2020
Last updated
01/28/2020
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