Individual
BRANDON SHAWN FAWSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
6295 EL PALOMINO DR, RIVERSIDE, CA 92509-6154
(951) 533-3154
Mailing address
6295 EL PALOMINO DR, RIVERSIDE, CA 92509-6154
(951) 533-3154
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
74779
CA
Other
Enumeration date
08/18/2016
Last updated
08/18/2016
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