Organization
AESCELON INC.
Active
Other names
Aescelon
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES PHILIP BLACKSHEAR MD (PRESIDENT)
(415) 689-6406
Entity
Organization
Contact information
Practice address
1389 JEFFERSON ST UNIT A507, OAKLAND, CA 94612-1670
(415) 689-6406
Mailing address
1389 JEFFERSON ST UNIT A507, OAKLAND, CA 94612-1670
(415) 689-6406
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114362175
—
OH
Enumeration date
08/28/2018
Last updated
08/28/2018
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