You will need the following in order to complete the application:
California and other licenses/certificates including DEA, if applicable
previous work experience (month and year are required), e.g.:
Kaiser Permanente
current and previous private/group practices
professional affiliations (hospital staff memberships and facility associations)
education and training including continuing medical/professional education (month and year are required),
current professional references
current and prior professional liability coverage
Please set aside at least 30 minutes to complete the online application. Once you start the application process, you will be able to save your entries and work on it at a later date until you submit the application.
