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1700066354
MARY JANE TANAWAN SAN ANTONIO
FONTANA, CA
NPI
1700066354
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: CA A96973)
Enumeration Date
2007-11-13
Last Update Date
2022-02-10
Business Address
MARY JANE TANAWAN SAN ANTONIO MD
9961 SIERRA AVE
FONTANA, CA 92335-6720
Phone number: 909-427-3910
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Mailing Address
MARY JANE TANAWAN SAN ANTONIO MD
9961 SIERRA AVE
FONTANA, CA 92335-6720
Phone number: 909-427-3910
Copy
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