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General NPI Number Information
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NPI Number | 1740715325
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Entity Type | Individual
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Provider Name | DR. AMANDA GOLAY
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Gender | Female
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Dates
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Enumeration Date | 04/20/2017
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Last Update Date | 04/20/2017
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Provider Practice Location Address
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Address Line | 24745 STEWART ST SHRYOCK HALL ROOM 234
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City | LOMA LINDA
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State | CA
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Zip | 92350-1719
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Country | US
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Telephone | 909-844-6644
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 W LUGONIA AVE SUITE 220
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City | REDLANDS
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State | CA
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Zip | 92374-9703
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Country | US
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Telephone | 909-844-6644
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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 | 75201
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License Number State | CA
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