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Private Practice Member Application
The annual membership fee for active private practitioners is $477. Retirees pay $72. You can pay by filling out the credit card form below.
Private practice membership is currently available to doctors practicing or residing within the state of California.
Name
*
First
Last
Degree
Workplace
Email
*
Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Annual Membership Fee
*
Private Practice Membership - $477
Retired Private Practice Membership - $72
Credit Card
*
Card Details
Cardholder Name
Δ