Individual
FAIRVEOLA BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3628 E IMPERIAL HWY STE 102, LYNWOOD, CA 90262-2600
(310) 637-2006
Mailing address
3628 E IMPERIAL HWY STE 102, LYNWOOD, CA 90262-2600
(310) 637-2006
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
48607
—
Other
Enumeration date
03/29/2018
Last updated
03/29/2018
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