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Active

California license 552572

License

Licensed by
Medical Board of California
License number
552572
Status
Active (Current)
First issued
May 19, 2021
Expires
May 31, 2027
Entity type
Organization

Classifications

More from the license record

License type code
8008

Contact

730 S Allied Way Ste C
El Segundo, CA 90245-5504
Los Angeles County