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General NPI Number Information
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NPI Number | 1487122198
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Entity Type | Individual
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Provider Name | ALEN NAIG MONDIDO
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Gender | Male
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Dates
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Enumeration Date | 11/12/2018
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Last Update Date | 11/12/2018
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Provider Practice Location Address
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Address Line | 128 MONTE VILLA CT
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City | CAMPBELL
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State | CA
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Zip | 95008-7090
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Country | US
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Telephone | 386-316-7680
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Fax |
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Provider Business Mailing Address
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Address Line | 128 MONTE VILLA CT
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City | CAMPBELL
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State | CA
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Zip | 95008-7090
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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 | 165246
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License Number State | CA
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