Samuel Agbonkpolo Valid NPI
Individual provider · Pharmacist · Fontana, CA
- NPI
- 1689145294
- Type
- Individual (Type 1)
- Primary specialty
- Pharmacist
- Specialty group
- Pharmacy Service Providers
- Taxonomy code
- 183500000X
- License number
- 79732 (CA)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2018-12-07
- Last updated
- 2018-12-07
Practice location
11121 Sierra Ave
Fontana, CA 92337-9310
(909) 356-9715