Individual
CHARLES TELESCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
400 N. PEPPER AVE., COLTON, CA 92324
(909) 580-6370
Mailing address
14645 WEST PARK AVE, BOULDER CREEK, CA 95006
(631) 618-7538
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/07/2014
Last updated
08/07/2014
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