Individual
CHARLES AGUSTIN AMADOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2019 N LAKE MEAD CIR, ORANGE, CA 92867-2471
(714) 244-9134
Mailing address
4126 NORMAL AVE, ORANGE, CA 92867-2471
(714) 244-9134
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
51709
CA
Other
Enumeration date
06/23/2014
Last updated
02/05/2015
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