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Individual
KAREN W LONG
Active
Individual
KAREN W LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMS-PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
OPA180510
CA
363AM0700X
Medical Physician Assistant
PA18051
CA
363AS0400X
Surgical Physician Assistant
Primary
PA18051
CA
Other
Enumeration date
07/16/2006
Last updated
07/16/2012
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