Individual
CHARLES JOSEPH MACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
MADERA HOSPITAL FAMILY HEALTH SERVICES, 1210 E. ALMOND AVE, MADERA, CA 93637
(559) 675-5530
(559) 675-5532
Mailing address
MADERA HOSPITAL FAMILY HEALTH SERVICES, 1210 E. ALMOND AVE, MADERA, CA 93637
(559) 675-5530
(559) 675-5532
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 12957
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA 12957
STATE LICENSE
CA
Enumeration date
06/25/2007
Last updated
03/18/2019
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