Mlt Kidane Physician Assistant Corporation
NPI #1225471956 in Moreno Valley, California
Provider Information
- NPI Number
- 1225471956
- Entity Type
- Organization
- Organization Name
- Mlt Kidane Physician Assistant Corporation
- Primary Specialty
- Physician Assistant - Medical
- Enumeration Date
- Apr 11, 2013
- Last Updated
- Apr 11, 2013
Practice Location
- Address
- 12981 PERRIS BLVD
- Address 2
- SUITE #101
- City
- Moreno Valley
- State
- California
- ZIP Code
- 92553-4102
- Phone
- (951) 571-0632
Authorized Official
- Name
- MS. MEAZA Z. KIDANE, PA
- Title
- PRESIDENT
- Phone
- (951) 571-0632
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Medical — Medical |
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