Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Jan 18, 2007
License(s)
PA12832 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 8225 LONG BEACH BLVD | South Gate, CA 90280-2010 | 323-585-2486 |
| LOCATION | 8225 LONG BEACH BLVD | South Gate, CA 90280-2010 | 323-585-2486 |
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