Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
May 6, 2008
License(s)
13616 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 289 W HUNTINGTON DR STE 401 | Arcadia, CA 91007-3493 | 626-254-0074 |
| MAILING | PO BOX 80011 | City Of Industry, CA 91716-8011 | 267-932-8856 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.