Individual
BLANCA LETICIA MORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
707 S GARFIELD AVE, STE. 201, ALHAMBRA, CA 91801-5859
(626) 656-1260
(626) 656-1264
Mailing address
707 S GARFIELD AVE, STE. 201, ALHAMBRA, CA 91801-5859
(626) 656-1260
(626) 656-1264
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 18649
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA 18649
CA LICENSE
CA
Enumeration date
11/06/2006
Last updated
07/08/2007
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