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1063141489
INGRID STEPHANIE MEDINA
MODESTO, CA
NPI
1063141489
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2022-06-09
Last Update Date
2022-07-07
Business Address
INGRID STEPHANIE MEDINA PA-C
600 COFFEE RD
MODESTO, CA 95355-4201
Phone number: 818-503-1233
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Mailing Address
INGRID STEPHANIE MEDINA PA-C
7652 CAMELLIA AVE
NORTH HOLLYWOOD, CA 91605-2905
Phone number: 818-823-3610
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