Individual
MISS LAUREN TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A
Contact information
Practice address
420 W ROWLAND ST, COVINA, CA 91723-2943
(626) 331-6411
(626) 251-1559
Mailing address
12942 BALTIMORE CT, CHINO, CA 91710-5937
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
51263
CA
Other
Enumeration date
12/21/2013
Last updated
05/04/2016
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