JACK THEODORE EZZEDINE

ALHAMBRA, CA
NPI1053137513
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363AM0700X Physician Assistant Medical
Enumeration Date2024-12-02
Last Update Date2024-12-02
Business Address
JACK THEODORE EZZEDINE
1000 S FREMONT AVE
ALHAMBRA, CA 91803-8800
Phone number: 626-457-4240
Mailing Address
JACK THEODORE EZZEDINE
678 E WALNUT ST UNIT 311
PASADENA, CA 91101-2283
Phone number: 714-713-7774
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