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1790324978
REZA KHODADADI
SAN CLEMENTE, CA
NPI
1790324978
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
3336C0003X Pharmacy, Community/Retail Pharmacy
Enumeration Date
2020-01-05
Last Update Date
2020-01-05
Business Address
REZA KHODADADI
638 CAMINO DE LOS MARES
SAN CLEMENTE, CA 92673-2848
Phone number: 949-487-9791
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Mailing Address
REZA KHODADADI
17252 CHESTNUT
IRVINE, CA 92612-2351
Phone number:
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