Individual
KEROLLOS MAKRMALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
17272 NEWHOPE ST, FOUNTAIN VALLEY, CA 92708-4210
(714) 942-4500
Mailing address
17272 NEWHOPE ST, FOUNTAIN VALLEY, CA 92708-4210
(714) 942-4500
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000038431
CA
Other
Enumeration date
03/14/2021
Last updated
03/14/2021
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