Individual
ANOULLA GHANNAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4331 PIEDMONT AVE, OAKLAND, CA 94611-4715
(650) 315-5421
Mailing address
30 OCEAN GROVE AVE, DALY CITY, CA 94015-3734
(650) 315-5421
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
L8455
CA
Other
Enumeration date
01/08/2015
Last updated
01/08/2015
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