Patient | Jody Allard | Preferred Language | Unspecified |
Date of birth | July 6, 1978 | Sex | Female |
Race | Unspecified
|
Ethnicity | Unspecified |
Contact info | Home:
9736 E Torino Ave Mesa, AZ 85212, US Tel (Mobile): +1(206)-316-6419 Tel (Primary Home): +1(206)-316-6419 Mail: allardjody@gmail.com |
Patient IDs | 2162848 2.16.840.1.113883.3.3710.999.44.88800115636.7770000101
MM0000000653 2.16.840.1.113883.3.3710.3 MODMED 2.16.840.1.113883.3.3710.200.501 115636PAT000000662 2.16.840.1.113883.3.3710.200.500 |
Document Id | test-id-134099384 2.16.840.1.113883.3.3710.0 |
Document Created: | April 7, 2024, 17:56:25 +0000 |
Author | Diana Tagaban, Jaime S. Schwartz, MD |
Contact info | Work Place:
240 S La Cienega Blvd Ste 200 Beverly Hills, CA 902113324, US Tel (Work Place): 3108825454 |
Encounter Id | |||
Encounter Date | From , to , | ||
Encounter Participant | |||
Contact info |
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Legal authenticator | Diana Tagaban signed at April 7, 2024, 17:56:25 +0000 |
Contact info | Work Place:
240 S La Cienega Blvd Ste 200 Beverly Hills, CA 902113324, US Tel (Work Place): 3108825454 |
Document maintained by | Jaime S. Schwartz, MD |
Contact info | Work Place:
240 S La Cienega Blvd Ste 200 Beverly Hills, CA 902113324, US Tel (Work Place): 3108825454 |