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General NPI Number Information
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NPI Number | 1346569126
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Entity Type | Individual
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Provider Name | ALGANESH T TEKELE PHARM. D
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Gender | Female
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Dates
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Enumeration Date | 05/19/2010
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Last Update Date | 05/19/2010
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Provider Practice Location Address
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Address Line | 12253 APPLE VALLEY RD
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City | APPLE VALLEY
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State | CA
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Zip | 92308-1701
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Country | US
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Telephone | 760-247-1123
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Fax |
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Provider Business Mailing Address
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Address Line | 18290 LAKEVIEW DR (SVL BOX 9840)
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City | VICTORVILLE
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State | CA
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Zip | 92395
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Country | US
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Telephone | 602-318-2146
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 61077
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License Number State | CA
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