Individual
GEORGINA CHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-3390
Mailing address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-3390
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA58347
CA
Other
Enumeration date
10/10/2018
Last updated
10/21/2020
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