Healthcare Provider Details

I. General information

NPI: 1972041663
Provider Name (Legal Business Name): FRANCIS GABRIEL MISION PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2017
Last Update Date: 07/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 E HOLT AVE
POMONA CA
91767-5625
US

IV. Provider business mailing address

611 E HOLT AVE
POMONA CA
91767-5625
US

V. Phone/Fax

Practice location:
  • Phone: 909-469-0083
  • Fax:
Mailing address:
  • Phone: 909-469-0083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number76132
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: