Individual
ELISA R REA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
696 E SANTA CLARA ST, SUITE 210, SAN JOSE, CA 95112-1911
(408) 295-9839
Mailing address
20700 LAKE CHABOT RD, STE 107, CASTRO VALLEY, CA 94546-5402
(408) 295-9839
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA22083
CA
Other
Enumeration date
03/20/2012
Last updated
01/03/2018
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