Individual
MOLLY ANNE CHURLONIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29100 PORTOLA PKWY STE G, LAKE FOREST, CA 92630-8712
(844) 254-6382
Mailing address
147 W CANADA APT B, SAN CLEMENTE, CA 92672-4664
(949) 306-1784
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA54884
CA
Other
Enumeration date
05/03/2017
Last updated
04/05/2022
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