Most Relevant Information
Provider Data
| NPI Number: | 1003697756 |
| Provider Name: | KENIA YULISSA MEDINA MORENO |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 88481 |
Most Important Dates
| Enumeration Date: | 10/09/2023 |
| Last Updated: | 10/09/2023 |
Provider Practice Location
1441 FLORIDA AVE
MODESTO
CA
953504404
Practice Location Phone/Fax
| Phone: | 2095763622 |
| Fax: |
Provider Mailing Location
2237 MCALLISTER LN
RIVERBANK
CA
953672673
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |