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ActiveCalifornia license 556940
License
- Licensed by
- Medical Board of California
- License number
- 556940
- Status
- Active (Current)
- First issued
- January 11, 2024
- Expires
- January 31, 2028
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
800 Pollard Rd Ste A
Los Gatos, CA 95032-1432
Los Gatos, CA 95032-1432
Santa Clara County