Individual
FAITH NICOLE CHILDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1520 SAN PABLO ST, LOS ANGELES, CA 90033-5310
(323) 442-5907
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(626) 457-6601
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
022622
NY
363A00000X
Physician Assistant
Primary
PA60437
CA
Other
Enumeration date
09/24/2018
Last updated
10/12/2022
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