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1053763144
SASIPAN JETAWATANA
NORTHRIDGE, CA
NPI
1053763144
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: CA 73148)
Enumeration Date
2016-07-12
Last Update Date
2022-04-28
Business Address
SASIPAN JETAWATANA
18350 ROSCOE BLVD
NORTHRIDGE, CA 91325-4109
Phone number: 818-688-5772
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Mailing Address
SASIPAN JETAWATANA
18350 ROSCOE BLVD STE 102
NORTHRIDGE, CA 91325-4193
Phone number: 818-885-7722
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