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Individual

LAURA MONICA MANOSALVA VARGAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
11301 WILSHIRE BLVD, BLDG.500, NSGY SUITE 6664, LOS ANGELES, CA 90073
(310) 478-3711
Mailing address
4175 W BROADWAY APT C, HAWTHORNE, CA 90250-4097
(561) 213-2902

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
56793
CA

Other

Enumeration date
05/16/2019
Last updated
09/28/2020
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