Individual
ADDISU YENET ALEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
200 VINTAGE WAY, NOVATO, CA 94945-5005
(206) 446-2112
Mailing address
200 VINTAGE WAY, NOVATO, CA 94945-5005
(206) 446-2112
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH81290
CA
Other
Enumeration date
12/08/2019
Last updated
12/08/2019
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