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Active

California license 562514

License

Licensed by
Medical Board of California
License number
562514
Status
Active (Current)
First issued
September 4, 2026
Expires
September 30, 2028
Entity type
Organization

Classifications

More from the license record

License type code
8008

Contact

1747 Hancock St Ste C
San Diego, CA 92101-1130
San Diego County