Registry details
Type
Individual
Primary specialty
Physician Assistant, Medical
Enumerated
Nov 24, 2022
License(s)
PA62159 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 400 W 30TH ST | Los Angeles, CA 90007-3320 | 213-284-3200 |
| MAILING | 2705 ELLISON DR | Beverly Hills, CA 90210-1207 | 310-404-1530 |
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