person
Carrie M Carrillo, PA
Surgical Physician Assistant in Fullerton, California
NPI 1588872089

Carrie M Carrillo is a Surgical Physician Assistant based in Fullerton, CA and is specialized in Surgical. Carrie M Carrillo practices in Fullerton, CA and has the professional credentials of PA. The NPI Number for Carrie M Carrillo is 1588872089 and holds a License No. PA17561 (California).

The current practice location address for Carrie M Carrillo is 2141 N Harbor Blvd Ste 35000, Fullerton, CA and can be reached out via phone at 714-626-8630. You can also correspond with Carrie M Carrillo through the mailing address at 2141 N HARBOR BLVD STE 35000, FULLERTON, CA - 92835-3831 (mailing address contact number: 714-626-8630).

Location: 2141 N Harbor Blvd Ste 35000, Fullerton, CA, 92835-3831
person
Provider Profile Details
NPI Number
1588872089
Provider Name
Carrie M Carrillo
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
2141 N Harbor Blvd Ste 35000, Fullerton, CA, 92835-3831
Phone Number
714-626-8630
Fax Number
Provider Enumeration Date
05/18/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PA17561 01 CA LICENSE
institution
Provider Business Practice Location Address Details
Address
2141 N Harbor Blvd Ste 35000
City
State
Zip
92835-3831
Phone Number
714-626-8630
Fax Number
person
Provider Business Mailing Address Details
Address
2141 N Harbor Blvd Ste 35000
City
State
Zip
92835-3831
Phone Number
714-626-8630
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PA17561 (California)
Definition
Definition to come...
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