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Individual

CHARLES W MAYFIELD JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1225 E LATHAM AVE STE B, HEMET, CA 92543-4423
(951) 929-2800
(951) 929-2303
Mailing address
1225 E LATHAM AVE STE B, HEMET, CA 92543-4423
(951) 929-2800
(951) 929-2303

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA16292
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
CA137652
CA
Enumeration date
01/23/2007
Last updated
07/21/2022
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