Individual
RYAN BAGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-7130
Mailing address
312 WINCHESTER ST, VALLEJO, CA 94590-7721
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
57307
CA
Other
Enumeration date
01/18/2018
Last updated
01/18/2018
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