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1265161699
MADELINE HAE SHIN LUNDGREN
LODI, CA
NPI
1265161699
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2022-06-09
Last Update Date
2022-06-20
Business Address
MADELINE HAE SHIN LUNDGREN PA
975 S FAIRMONT AVE
LODI, CA 95240-5118
Phone number: 209-334-3411
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Mailing Address
MADELINE HAE SHIN LUNDGREN PA
2736 RIVER COVE DR
RIVERBANK, CA 95367-3319
Phone number:
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