Individual
KELLIE QUAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6000 WOODMAN AVE, VAN NUYS, CA 91401-6310
(310) 770-2842
Mailing address
14449 BENEFIT ST APT 5, SHERMAN OAKS, CA 91423-4037
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
R53135
CA
Other
Enumeration date
02/15/2007
Last updated
07/08/2007
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