Individual
KEVIN WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3055 W FLORIDA AVE, HEMET, CA 92545-3617
(951) 652-0866
Mailing address
3055 W FLORIDA AVE, HEMET, CA 92545-3617
(951) 652-0866
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
78104
CA
Other
Enumeration date
08/24/2019
Last updated
08/24/2019
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