| Patient | Michelle Decena | Preferred Language | Unspecified |
| Date of birth | September 16, 1977 | Sex | Female |
| Race | Unspecified
|
Ethnicity | Unspecified |
| Contact info | Primary Home:
247 Palmetto Walk Drive Summerville, SC 29486, US Tel (Mobile): +1(864)-247-2150 Mail: ladecenajr@gmail.com Mail: ladecenajr@gmail.com |
Patient IDs | 534218 2.16.840.1.113883.3.3710.999.44.88800115636.7770000101
12898 2.16.840.1.113883.3.3710.3 Ellkay 2.16.840.1.113883.3.3710.200.501 12898 2.16.840.1.113883.3.3710.200.500 |
| Document Id | test-id-1602427677 2.16.840.1.113883.3.3710.0 |
| Document Created: | April 6, 2024, 20:15:20 +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 |
|
||
| Legal authenticator | Diana Tagaban signed at April 6, 2024, 20:15:20 +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 |