Registry details
Type
Individual
Primary specialty
Internal Medicine
Enumerated
Jun 20, 2012
License(s)
20A14213 (CA), 5101020062 (MI), 20A14213 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 10884 SANTA MONICA BLVD 3RD FLOOR | Los Angeles, CA 90025-4646 | 310-446-4400 |
| MAILING | 2409 ARTESIA BLVD FL 2 | Redondo Beach, CA 90278-3207 | 424-276-4700 |
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