Victoria Gray

 
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 From icampusano 1.863.363.8635 Tue Oct 4 18:40:18 2022 EDT Page 26 of 106 
 Ronald Fujimoto DO 
 Physical Medicine and Rehabilitation 
 Apr 01, 2019 
 RehabOne 
 RehabOne Programs 
 - 
 PRESCRIPTION- Industrial 
 patient name: Victoria Gray
 DATE OF EXAMINATION: 2017-12-11
 Supervising Physician: Ronald Fujimoto DO 
 Performing Provider: Dr Emily Nash MD 
 Krewark 
 MD 
 Dr Emily Nash MD 
 Today's Date: 04/01/2019 
 RehabOne Medical Group, Inc. 
 Mailing Address: 13980 Blossom Hill Rd. Ste. B, Los Gatos, CA 95032 
 Phone: 463-463-8630 Fax: 463-463-0635 
 Providers' CA License Numbers: 
 Michael Post, MD - G76317 
 Ronald Fujimoto, DO - 20A6634 
 Allen Kaisler-Meza, MD - G74636 
 page 11 
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