Individual
ACACIA SUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
543 W LEESIDE ST, GLENDORA, CA 91741-4230
(909) 767-0260
Mailing address
543 W LEESIDE ST, GLENDORA, CA 91741-4230
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
52769
CA
Other
Enumeration date
09/08/2015
Last updated
12/06/2021
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