Individual
ATA ELMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3308 N DINUBA BLVD, VISALIA, CA 93291-8718
(559) 302-1851
Mailing address
1001 SIERRA AVE, CLOVIS, CA 93612-1261
(704) 685-5392
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
83003
CA
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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