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Individual

FOLUSHO OTTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2853 GROOM DR, RICHMOND, CA 94806-2664
(510) 278-3600
Mailing address
16546 RUSSELL CT, SAN LEANDRO, CA 94578-1561
(510) 278-3600

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
12/31/2007
Last updated
01/12/2008
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