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Individual

CHARIS FASOLDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
77 VAN NESS AVE APT 302, SAN FRANCISCO, CA 94102-6042
(415) 379-9015
Mailing address
147 MARLBOROUGH RD, ROCHESTER, NY 14619-1409
(585) 775-6378

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
06/01/2023
Last updated
06/01/2023
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