Individual
CHLOE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5700 FIRESTONE BLVD, SOUTH GATE, CA 90280-3704
(562) 372-0037
Mailing address
PO BOX 31506, LOS ANGELES, CA 90031-0506
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
031243651
OH
183500000X
Pharmacist
Primary
63820
CA
Other
Enumeration date
11/10/2011
Last updated
11/10/2011
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