Individual
CARRIE GORHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26439 YNEZ RD STE B, TEMECULA, CA 92591-5621
(909) 816-3645
Mailing address
27625 STANFORD DR, TEMECULA, CA 92591-2849
(909) 816-3645
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
L8424
CA
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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