Registry details
Type
Individual
Primary specialty
Physician Assistant, Medical
Enumerated
Jan 14, 2019
License(s)
PA56451 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 3301 C ST STE 1500 | Sacramento, CA 95816-3371 | 916-734-7463 |
| MAILING | 4860 Y ST STE 3740 | Sacramento, CA 95817-2307 | 916-734-7463 |
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