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1619461696
FAIZ ENDRO KUSUMO
FRESNO, CA
NPI
1619461696
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2018-06-21
Last Update Date
2018-06-21
Business Address
FAIZ ENDRO KUSUMO MD
1313 E HERNDON AVE
FRESNO, CA 93720-3306
Phone number: 559-450-5375
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Mailing Address
FAIZ ENDRO KUSUMO MD
1313 E HERNDON AVE
FRESNO, CA 93720-3306
Phone number:
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