Organization
GLYCOMINDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AVINOAM A DUKLER PH.D. (OFFICER)
(805) 791-2094
Entity
Organization
Contact information
Practice address
4685 RUNWAY ST, SUITE J, SIMI VALLEY, CA 93063-3470
(805) 791-2094
Mailing address
4685 RUNWAY ST STE J, SIMI VALLEY, CA 93063-3470
(805) 791-2094
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
CA
Other
Enumeration date
06/23/2010
Last updated
05/17/2011
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