Registry details
Type
Individual
Primary specialty
Internal Medicine
Enumerated
Jan 13, 2017
License(s)
20A15952 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 6601 WHITE FEATHER RD | Joshua Tree, CA 92252-6607 | 760-366-3711 |
| MAILING | 8161 E KAISER BLVD UNIT 30402 | Anaheim, CA 92809-0534 |
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