Registry details
Type
Individual
Primary specialty
Physician Assistant, Medical
Enumerated
Jul 13, 2020
License(s)
58382 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 246 W COLLEGE ST FL 3 | Covina, CA 91723-1910 | 626-915-1911 |
| MAILING | 293 N STATE COLLEGE BLVD APT 3068 | Orange, CA 92868-5724 | 978-325-1322 |
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