Individual
BRYAN HATAISHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13171 MINDANAO WAY, MARINA DEL REY, CA 90292-6307
(310) 222-5665
Mailing address
1000 W. CARSON ST. N-22, TORRANCE, CA 90502
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
39448
CA
Other
Enumeration date
11/04/2015
Last updated
01/15/2016
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