Individual
CAROL FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25965 NORMANDIE AVE, HARBOR CITY, CA 90710-3416
(424) 328-2110
Mailing address
10736 JEFFERSON BLVD, #684, CULVER CITY, CA 90230-4933
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH39295
CA
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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