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Individual

DEBORAH PALMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2060 HUNTINGTON DR STE 5, SAN MARINO, CA 91108-2044
(626) 570-1993
(626) 570-4993
Mailing address
2060 HUNTINGTON DR STE 5, SAN MARINO, CA 91108-2044
(626) 570-1993
(626) 570-4993

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
BL 001681
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
DME02525F
CA
Enumeration date
07/26/2006
Last updated
11/24/2008
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