Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Feb 11, 2013
License(s)
22827 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 2450 STANLEY | Tustin, CA 92782-1269 | 818-515-7949 |
| LOCATION | 500 W WILLOW ST | Long Beach, CA 90806-2831 | 562-427-1700 |
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