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Individual

MRS. ELIZABETH A SEVERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
31537 RANCHO PUEBLO RD, TEMECULA, CA 92592-4841
(951) 303-2277
Mailing address
31537 RANCHO PUEBLO RD, TEMECULA, CA 92592-4841
(951) 303-2277

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA18273
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA 18273
MEDICAL LICENSE
CA
Enumeration date
06/29/2006
Last updated
11/22/2010
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