Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Jan 31, 2019
License(s)
PA56240 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1225 WILSHIRE BLVD | Los Angeles, CA 90017-1901 | 213-977-2121 |
| MAILING | PO BOX 31309 | Los Angeles, CA 90031-0309 | 213-977-2121 |
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