Registry details
Type
Individual
Primary specialty
Physician Assistant, Medical
Enumerated
Oct 3, 2017
License(s)
55679 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 9850 GENESEE AVE STE 320 | La Jolla, CA 92037 | 858-554-1212 |
| MAILING | 9850 GENESEE AVE STE 320 | La Jolla, CA 92037-1208 | 858-554-1212 |
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