Individual
ALYSSA DER MUGRDECHIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2071 HERNDON AVE, CLOVIS, CA 93611-6101
(559) 324-5100
Mailing address
416 W SAMPLE AVE, CLOVIS, CA 93612-5734
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A180049
CA
390200000X
Student in an Organized Health Care Education/Training Program
PTL487
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/05/2019
Last updated
08/16/2022
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