Individual
CANICE NDUBISI ADOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
407 E 10TH ST, PITTSBURG, CA 94565-2652
(510) 200-5147
Mailing address
407 E 10TH ST, PITTSBURG, CA 94565-2652
(510) 200-5147
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
F5277294
CA
Other
Enumeration date
01/12/2021
Last updated
01/12/2021
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