Organization
MLT KIDANE PHYSICIAN ASSISTANT CORPORATION
Active
Other names
Med-Hanit Alem Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MEAZA Z. KIDANE PA (PRESIDENT)
(951) 571-0632
Entity
Organization
Contact information
Practice address
12981 PERRIS BLVD, SUITE #101, MORENO VALLEY, CA 92553-4102
(951) 571-0632
(951) 571-4149
Mailing address
12981 PERRIS BLVD, SUITE #101, MORENO VALLEY, CA 92553-4102
(951) 571-0632
(951) 571-4149
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA20768
CA
Other
Enumeration date
04/11/2013
Last updated
04/11/2013
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