Individual
LLESENIA MORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
949 CALHOUN PL, D, HEMET, CA 92543-4403
(951) 652-8000
Mailing address
949 CALHOUN PL, D, HEMET, CA 92543-4403
(951) 652-8000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
53092
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/06/2015
Last updated
06/12/2017
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