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DR. SAMUEL AGBONKPOLO

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1689145294

Individual Registrant:
DR. SAMUEL  AGBONKPOLO 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
11121 SIERRA AVE  FONTANA, CA 92337-9310 US
Tel: 909-356-9715  Fax: --

Contact information for business:
11121 SIERRA AVE  FONTANA, CA 92337-9310 US
Tel: 909-356-9715  Fax: --

Registration Information:
NPI: 1689145294
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
CA79732

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS CA - Page 1



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