Individual
ALEXIS CHRISTINE KOFOED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 EMBARCADERO CTR # R-1203, SAN FRANCISCO, CA 94111-3628
(707) 673-6506
Mailing address
2619 SEMINOLE CT, FAIRFIELD, CA 94534-7871
(707) 673-6506
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA55669
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA55669
—
CA
Enumeration date
06/25/2018
Last updated
06/25/2018
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