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Individual

JOAN EASTLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
432 PANAMA AVE, LONG BEACH, CA 90814-1909
(562) 961-3831
Mailing address
432 PANAMA AVE, LONG BEACH, CA 90814-1909
(562) 961-3831

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
14906
CA

Other

Enumeration date
01/14/2013
Last updated
01/14/2013
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