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Individual

KEVIN DANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4573 STAR PASS RD, RIVERSIDE, CA 92507-7812
(951) 867-0905
Mailing address
4573 STAR PASS RD, RIVERSIDE, CA 92507-7812
(951) 867-0905

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
190578
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
90590616D45087
CA
Enumeration date
10/12/2022
Last updated
10/12/2022
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