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Active

California license 558391

License

Licensed by
Medical Board of California
License number
558391
Status
Active (Current)
First issued
October 30, 2024
Expired
October 31, 2026
Entity type
Organization

Classifications

More from the license record

License type code
8008

Contact

525 Middlefield Rd Apt 685
Redwood City, CA 94063-1489
San Mateo County