Individual
AGNES FUGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1204 SAN FERNANDO RD, SAN FERNANDO, CA 91340-3205
(818) 361-2679
Mailing address
19424 SOLEDAD CANYON RD, CANYON COUNTRY, CA 91351-2631
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
57318
CA
Other
Enumeration date
04/18/2019
Last updated
04/18/2019
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