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1982041604
ANDRE CIPTA
GLENDALE, CA
NPI
1982041604
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: CA a124104)
Enumeration Date
2013-06-04
Last Update Date
2021-12-03
Business Address
-- ANDRE CIPTA
801 S CHEVY CHASE DR 230
GLENDALE, CA 91205-4431
Phone number: 818-500-5525
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Mailing Address
-- ANDRE CIPTA
801 S CHEVY CHASE DR 230
GLENDALE, CA 91205-4431
Phone number:
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