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General NPI Number Information
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NPI Number | 1295310175
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Entity Type | Individual
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Provider Name | GABRIEL JUAREZ JR.
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Gender | Male
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Dates
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Enumeration Date | 03/12/2021
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Last Update Date | 03/12/2021
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Provider Practice Location Address
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Address Line | 1808 VERDUGO BLVD STE 111
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City | GLENDALE
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State | CA
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Zip | 91208-1449
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Country | US
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Telephone | 818-952-2223
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Fax |
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Provider Business Mailing Address
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Address Line | 7652 WENTWORTH ST
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City | TUJUNGA
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State | CA
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Zip | 91042-1637
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number |
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License Number State |
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