ALPHA ISCANDARI SANUSI

RIVERSIDE, CA
NPI1710534821
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224P00000X Prosthetist
(Licence: CA  C51502)
Additional Taxonomies222Z00000X 
(Licence: CA  C51502)
Enumeration Date2019-08-22
Last Update Date2019-08-22
Business Address
ALPHA ISCANDARI SANUSI BOCPO
1760 CHICAGO AVE STE L21
RIVERSIDE, CA 92507-2326
Phone number: 626-622-3359
Mailing Address
ALPHA ISCANDARI SANUSI BOCPO
1760 CHICAGO AVE STE L21
RIVERSIDE, CA 92507-2326
Phone number: 626-622-3359
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