Individual
EDGAR JESUS MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
4510 E PACIFIC COAST HWY STE 305, LONG BEACH, CA 90804-6960
(562) 537-4225
Mailing address
4510 E PACIFIC COAST HWY STE 305, LONG BEACH, CA 90804-6960
(562) 537-4225
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
32653
CA
Other
Enumeration date
05/21/2018
Last updated
05/21/2018
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