Individual
MRS. MICHELLE CHAN CAPULONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3565 DEL AMO BLVD, TORRANCE, CA 90503-1637
(310) 214-0811
Mailing address
3565 DEL AMO BLVD, TORRANCE, CA 90503-1637
(310) 214-0811
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA18763
CA
Other
Enumeration date
12/07/2006
Last updated
08/31/2023
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