Facts
- Status
- A
- Credential
- MS, BCHN
- Type
- Individual
- Enumeration date
- 2023-05-10
- Last updated
- 2023-05-10
Licenses
- License CA
- Number not in the file
- License OR
- Number not in the file
Location
- Practice location
- 28481 RANCHO CALIFORNIA RD STE 202
- City
- TEMECULA CA
- Postal code
- 925903619
- Phone
- 951-404-8805
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.