Individual
ANDREW AKAPOB KAEWTAVORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
725 CENTER DR, SAN MARCOS, CA 92069-3536
(760) 871-6867
Mailing address
1427 N IVY ST, ESCONDIDO, CA 92026-2722
(909) 247-5534
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
82842
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82842
REGISTERED PHARMACIST
CA
Enumeration date
08/31/2021
Last updated
08/31/2021
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