Registry details
Type
Individual
Primary specialty
Physician Assistant, Medical
Enumerated
Jan 11, 2007
License(s)
PA 19000 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 3630 IMPERIAL HIGHWAY | Lynwood, CA 90262 | 310-900-4534 |
| MAILING | 831 GRAYNOLD AVE | Glendale, CA 91202 | 818-841-7115 |
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