Individual
ELIZABETH MADISON PERNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12264 EL CAMINO REAL, SAN DIEGO, CA 92130-3058
(858) 509-9600
Mailing address
3620 HARVARD DR, OCEANSIDE, CA 92056-4131
(757) 510-6664
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306606368
VA
Other
Enumeration date
10/03/2024
Last updated
10/03/2024
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