Individual
BEVERLY SANSONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9940 TALBERT AVE, SUITE 303, FOUNTAIN VALLEY, CA 92708-5153
(714) 378-5606
(714) 378-5621
Mailing address
9940 TALBERT AVE, SUITE 303, FOUNTAIN VALLEY, CA 92708-5153
(714) 378-5606
(714) 378-5621
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G53820
CA
Other
Enumeration date
04/19/2006
Last updated
04/21/2010
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