Individual
CHI DO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
455 S MAIN ST, RED BLUFF, CA 96080-4315
(530) 529-5530
Mailing address
100 HILLTOP DR APT 34, REDDING, CA 96003-2816
(301) 366-9482
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
77861
CA
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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