Individual
JUDITH FAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
10833 LE CONTE AVE STE 12-159, LOS ANGELES, CA 90095-7701
(310) 206-6516
Mailing address
1935 MEDICAL DISTRICT DR, DALLAS, TX 75235-7701
(214) 456-6533
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
GC000794
CA
Other
Enumeration date
06/14/2012
Last updated
04/22/2020
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