Individual
ANTWON ERVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4175 CHARLENE DR, LOS ANGELES, CA 90043-1552
(757) 348-3015
Mailing address
1800 W SLAUSON AVE, LOS ANGELES, CA 90047-1126
(323) 292-1941
(323) 292-4256
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
58039
TX
183500000X
Pharmacist
Primary
72576
CA
Other
Enumeration date
02/11/2017
Last updated
08/05/2020
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