Individual
CAMERON GRADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
26111 BOUQUET CANYON RD STE G3, SAUGUS, CA 91350-2670
(661) 254-0803
Mailing address
26111 BOUQUET CANYON RD STE G3, SAUGUS, CA 91350-2670
Taxonomy
Speciality
Code
Description
License number
State
111NR0200X
Radiology Chiropractor
Primary
DC15810
CA
Other
Enumeration date
02/12/2007
Last updated
02/23/2012
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