Individual
CHARLES KEITH MCCORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
16850 BEAR VALLEY RD, VICTORVILLE, CA 92395-5794
(760) 241-8000
(760) 962-8021
Mailing address
1005 DR DB TODD JR BLVD, NASHVILLE, TN 37208-3501
(615) 327-5944
(615) 327-5597
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA22512
CA
Other
Enumeration date
09/14/2012
Last updated
01/04/2019
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