Individual
MR. GODWILL TABE TAMUNANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
407 N AVALON BLVD, WILMINGTON, CA 90744-5803
(310) 834-9574
(310) 522-9639
Mailing address
407 N AVALON BLVD, WILMINGTON, CA 90744-5803
(310) 834-9574
(310) 522-9639
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
44548
CA
Other
Enumeration date
07/11/2006
Last updated
07/08/2007
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