Individual
COREY MACEDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1604 S SANTA FE AVE, SUITE 403, SAN JACINTO, CA 92583-5060
(951) 654-2026
(951) 654-9927
Mailing address
5870 ARLINGTON AVE, SUITE 103, RIVERSIDE, CA 92504-2037
(951) 683-6596
(951) 683-4239
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
CA
Other
Enumeration date
02/15/2011
Last updated
02/15/2011
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