Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Feb 9, 2015
License(s)
52282 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 6195 LUSK BLVD STE 250 | San Diego, CA 92121-3715 | 858-851-1188 |
| MAILING | 7464 GOLFCREST DR | San Diego, CA 92119-1224 | 405-606-5199 |
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