Individual
BANN ABOUDI ALLYAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3000 S ARCHIBALD AVE, ONTARIO, CA 91761-7918
(909) 773-0073
(909) 773-0158
Mailing address
3000 S ARCHIBALD AVE, ONTARIO, CA 91761-7918
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
13348
NV
183500000X
Pharmacist
Primary
48649
CA
Other
Enumeration date
06/21/2010
Last updated
06/21/2010
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