Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Oct 31, 2006
License(s)
PA13963 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1840 BRIDGEGATE ST STE 1 | Westlake Village, CA 91361-1466 | 805-497-7811 |
| LOCATION | 3484 E. FIRST ST. | Los Angeles, CA 90063-2946 | 323-268-4436 |
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