Individual
ALICIA MARIE MUCCIGROSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6330 SAN VICENTE BLVD, SUITE 310, LOS ANGELES, CA 90048-5425
(310) 855-0751
Mailing address
6330 SAN VICENTE BLVD, SUITE 310, LOS ANGELES, CA 90048-5425
(310) 855-0751
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
21789
CA
363AM0700X
Medical Physician Assistant
014104-1
NY
Other
Enumeration date
07/25/2010
Last updated
11/20/2013
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