Individual
TINA MY QUACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
160 S 7TH AVE, LA PUENTE, CA 91746-3211
(626) 961-8971
Mailing address
160 S 7TH AVE, LA PUENTE, CA 91746-3211
(626) 961-8971
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-WMLHCJ
CA
Other
Enumeration date
06/05/2025
Last updated
06/05/2025
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