Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Aug 19, 2007
License(s)
16496 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 11123 RICHMONT RD PO BOX 324 | Loma Linda, CA 92354-2967 | 909-684-6022 |
| LOCATION | 11301 WILSHIRE BLVD | Los Angeles, CA 90073-1003 | 310-478-3711 |
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