Individual
TRICIA GRACE CHARLES-COWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3989 W STETSON AVE STE 202, HEMET, CA 92545-9697
(951) 652-3558
(951) 652-5547
Mailing address
3660 PARK SIERRA DR STE 203, RIVERSIDE, CA 92505-3071
(951) 687-3400
(951) 687-7630
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
20A14022
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CA249622
—
CA
Enumeration date
08/02/2012
Last updated
07/29/2021
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