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Individual

CHANDA DOMANTAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
915 BRYANT ST, SAN FRANCISCO, CA 94103-4514
(415) 777-9953
(415) 777-4717
Mailing address
915 BRYANT ST, SAN FRANCISCO, CA 94103-4514
(415) 777-9953
(415) 777-4717

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
183700000X
Pharmacy Technician
81828
CA
251S00000X
Community/Behavioral Health Agency
81828
CA

Other

Enumeration date
02/03/2015
Last updated
03/20/2015
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