Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Dec 3, 2020
License(s)
PA62083 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 2100 MACK BLVD FL 2 | Allentown, PA 18103-5622 | 484-884-4500 |
| LOCATION | 101 THE CITY DR S | Orange, CA 92868-3201 | 714-456-8888 |
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