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Individual

AZUCENA PORRAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
5546 ROSEMEAD BLVD STE 102, TEMPLE CITY, CA 91780-1855
(626) 285-9600
(626) 285-2214
Mailing address
5546 ROSEMEAD BLVD STE 102, TEMPLE CITY, CA 91780-1855
(626) 285-9600
(626) 285-2214

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
A25493
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A254930
CA
01
A25493
DOCTORS STATE LICENSE
CA
Enumeration date
09/21/2006
Last updated
07/08/2007
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