Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Jul 5, 2022
License(s)
65315 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2704 E WILLOW ST | Signal Hill, CA 90755-2217 | 562-490-9900 |
| MAILING | 588 LONGMEADOW ST | Longmeadow, MA 01106-2212 | 248-739-0686 |
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