Boulder Care Provider Group, P.C.
ExpiredCalifornia license 551785
License
- Licensed by
- Medical Board of California
- License number
- 551785
- Status
- Expired (Delinquent)
- First issued
- November 3, 2020
- Expired
- November 30, 2022
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
8581 Santa Monica Blvd # 483
West Hollywood, CA 90069-4120
West Hollywood, CA 90069-4120
Los Angeles County