Medprov
ActiveCalifornia license 560542
License
- Licensed by
- Medical Board of California
- License number
- 560542
- Status
- Active (Current)
- First issued
- November 5, 2025
- Expires
- November 30, 2027
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
2036 Hornblend St Fl 2
San Diego, CA 92109-4638
San Diego, CA 92109-4638
San Diego County