Individual
AVINASH MAMIDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM
Contact information
Practice address
805 VETERANS BLVD, REDWOOD CITY, CA 94063-1734
(650) 853-6600
Mailing address
805 VETERANS BLVD, REDWOOD CITY, CA 94063-1734
(650) 853-6600
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
57504
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57504
CA LICENSE
CA
Enumeration date
04/26/2010
Last updated
04/26/2010
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