Individual
MRS. CAROLINE SELF ONSTOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Mailing address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3775
AZ
363A00000X
Physician Assistant
PA18212
CA
363AS0400X
Surgical Physician Assistant
PA18212
CA
Other
Enumeration date
03/31/2006
Last updated
09/03/2020
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