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1285390815
ANTHONY WONG PHAN
WEST COVINA, CA
NPI
1285390815
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103K00000X Behavior Analyst
(Licence: CA 1-21-54001)
Enumeration Date
2021-11-09
Last Update Date
2021-11-09
Business Address
ANTHONY WONG PHAN
835 W CHRISTOPHER ST
WEST COVINA, CA 91790-3702
Phone number: 626-943-7772
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Mailing Address
ANTHONY WONG PHAN
9060 HUNTINGTON DR
SAN GABRIEL, CA 91775-1332
Phone number: 626-943-7772
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