Individual
ELVIA L CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4004 BEYER BLVD, SAN YSIDRO, CA 92173-2007
(619) 428-4463
(619) 428-2625
Mailing address
4004 BEYER BLVD, SAN YSIDRO, CA 92173-2007
(619) 428-4463
(619) 428-2625
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA17240
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FHC18880F
MEDICAL
—
Enumeration date
10/25/2006
Last updated
12/18/2007
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