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1700186491
BRIAN IM
CERRITOS, CA
NPI
1700186491
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA PA21262)
Enumeration Date
2010-10-27
Last Update Date
2023-09-21
Business Address
BRIAN IM
17811 CECELIA PL
CERRITOS, CA 90703-8712
Phone number: 562-754-0828
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Mailing Address
BRIAN IM
17811 CECELIA PL
CERRITOS, CA 90703-8712
Phone number: 562-754-0828
Copy
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