Individual
CHANTAL ANGELIQUE FRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2105 FOREST AVE, SAN JOSE, CA 95128-1425
(408) 947-2500
Mailing address
2105 FOREST AVE, SAN JOSE, CA 95128-1425
(408) 947-2500
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA61339
CA
Other
Enumeration date
08/03/2022
Last updated
08/03/2022
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