Individual
CECILIA KIMLOAN PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 MENDOCINO AVE, SANTA ROSA, CA 95403-3115
(707) 569-3111
Mailing address
2300 MENDOCINO AVE, SANTA ROSA, CA 95403-3115
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
75706
CA
Other
Enumeration date
04/26/2016
Last updated
10/13/2016
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