Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Aug 2, 2020
License(s)
PA57561 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 133 THE PROMENADE N UNIT 112 | Long Beach, CA 90802-4728 | 714-299-2257 |
| MAILING | 133 THE PROMENADE N UNIT 112 | Long Beach, CA 90802-4728 |
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