Individual
DEMI CARLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
25455 BARTON RD STE 204B, LOMA LINDA, CA 92354-3130
(909) 558-6600
Mailing address
FILE # 54701, LOS ANGELES, CA 90074-4701
(909) 651-4300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
52154
CA
Other
Enumeration date
11/14/2014
Last updated
09/19/2024
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