Individual
LACEE OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2592 N SANTIAGO BLVD, ORANGE, CA 92867-1862
(714) 330-7921
Mailing address
7290 EDINGER AVE UNIT 4138, HUNTINGTON BEACH, CA 92647-0957
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA57170
CA
Other
Enumeration date
11/20/2019
Last updated
11/20/2019
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