Individual
MR. MICHAEL THOMAS LANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
8891 CENTRAL AVE, MONTCLAIR, CA 91763-1618
(909) 625-4848
Mailing address
4374 9TH ST, RIVERSIDE, CA 92501-3106
(951) 809-2094
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA18755
CA
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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