Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Jun 3, 2026
License(s)
310264 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 429 GALAXY CT | Milpitas, CA 95035-6205 | |
| LOCATION | 10635 SANTA MONICA BLVD STE 165 | Los Angeles, CA 90025-8306 | 310-273-0877 |
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