Individual
CORINE MICHELLE RIEDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 S WELLS RD, VENTURA, CA 93004-1377
(805) 659-1740
(805) 659-1740
Mailing address
200 S WELLS RD, VENTURA, CA 93004-1377
(805) 659-1740
(805) 659-1740
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA21988
CA
Other
Enumeration date
11/08/2011
Last updated
05/01/2013
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