Individual
MR. CHARLES FRANCIS WETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
11180 WARNER AVE STE 353, FOUNTAIN VALLEY, CA 92708-7516
(714) 968-6789
(714) 202-2626
Mailing address
31581 CANYON ESTATES DR, SOUTHERN CALIFORNIA PRIMARY CARE MEDICAL GROUP, LAKE ELSINORE, CA 92532-0424
(951) 244-3500
(951) 244-3535
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA13867
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA13687
CA STATE LIC
CA
Enumeration date
05/01/2006
Last updated
03/31/2023
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