Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Feb 5, 2016
License(s)
53202 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 6815 NOBLE AVE | Van Nuys, CA 91405-3796 | 818-901-6600 |
| MAILING | 6815 NOBLE AVE | Van Nuys, CA 91405-3796 | 818-901-6600 |
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