Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Jun 17, 2006
License(s)
A93142 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 200 OCEANGATE SUITE 100 | Long Beach, CA 90802-4302 | 562-499-6191 |
| LOCATION | 445 E. ANAHEIM STREET #H | Wilmington, CA 90744-4600 | 310-518-6146 |
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