Individual
ANU THANKACHAN THADAVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1159 W 36TH ST, LOS ANGELES, CA 90007-3925
(347) 466-1530
Mailing address
1159 W 36TH ST APT 3, LOS ANGELES, CA 90007-3925
(347) 466-1530
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH82102
CA
Other
Enumeration date
03/03/2020
Last updated
03/03/2020
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