Individual
COURTNEY PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 W 19TH ST, COSTA MESA, CA 92627-5060
(714) 922-4100
Mailing address
601 WEST 19TH ST, COSTA MESA, CA 92627
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
22352
CA
Other
Enumeration date
11/16/2012
Last updated
11/16/2012
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