Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Apr 6, 2007
License(s)
PA17760 (CA), PA17760 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 16418 MYRA LN | Cerritos, CA 90703-1524 | 714-318-4843 |
| LOCATION | 12522 LAMBERT RD | Whittier, CA 90606-2758 | 562-789-5420 |
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