Individual
BAO THAT TON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12001 EUCLID ST, GARDEN GROVE, CA 92840-3332
(714) 530-1071
Mailing address
1883 W CHALET AVE, ANAHEIM, CA 92804-5561
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
66757
CA
Other
Enumeration date
03/09/2022
Last updated
03/09/2022
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