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NPI Code Detail

MEDICARE: SUSANA ANGUIANO

MEDICARE:   SUSANA  ANGUIANO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183700000XPharmacy Technician148604CA

General Provider Information

NPI Number : 1790460913
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSANA ANGUIANO
Provider Business Mailing Address
First Line : 607 E MAGNOLIA ST
Second Line :
City : STOCKTON
State : CA
Zip : 95202-1846
Country : US
Telephone Number : 209-616-6600
Fax Number :
Provider Business Practice Location Address
First Line : 607 E MAGNOLIA ST
Second Line :
City : STOCKTON
State : CA
Zip : 95202-1846
Country : US
Telephone Number : 209-616-6600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2023
Last Update Date : 06/15/2023

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Directions to “ SUSANA ANGUIANO ” Practice Location

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