Individual
ASHISH K MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1575 W PACHECO BLVD, LOS BANOS, CA 93635-8505
(209) 826-9653
Mailing address
1301 CANAL FARM LN APT 5B, LOS BANOS, CA 93635-3867
(408) 784-4719
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
78642
CA
Other
Enumeration date
08/01/2018
Last updated
08/01/2018
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