Chc Provider Network
ExpiredCalifornia license 554217
License
- Licensed by
- Medical Board of California
- License number
- 554217
- Status
- Expired (Delinquent)
- First issued
- June 15, 2022
- Expired
- June 30, 2024
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
7705 Seville Ave Ste C
Huntington Park, CA 90255-6570
Huntington Park, CA 90255-6570
Los Angeles County