Registry details
Type
Individual
Primary specialty
Physician Assistant, Medical
Enumerated
Oct 9, 2018
License(s)
—
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 544 N GLENDALE AVE STE A | Glendale, CA 91206-3311 | 818-241-4331 |
| MAILING | 1808 VERDUGO BLVD STE 414 | Glendale, CA 91208-1474 | 818-265-5400 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.