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Charese M Fannin, PA
Medical Physician Assistant in Lynwood, California
NPI 1770517799

Charese M Fannin is a Medical Physician Assistant based in Westminster, CA and is specialized in Medical. Charese M Fannin practices in Lynwood, CA and has the professional credentials of PA. The NPI Number for Charese M Fannin is 1770517799 and holds a License No. PA12007 (California).

The current practice location address for Charese M Fannin is 3630 East Imperial Highway, Lynwood, CA and can be reached out via phone at 310-900-8900.

Location: 3630 East Imperial Highway, Lynwood, CA, 92685-2110
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1770517799
Provider Name
Charese M Fannin
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
3630 East Imperial Highway, Lynwood, CA, 92685-2110
Phone Number
310-900-8900
Fax Number
Provider Enumeration Date
07/10/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PA12007 05 CA
institution
Provider Business Practice Location Address Details
Address
3630 East Imperial Highway
City
Lynwood
State
California
Zip
90262-2678
Phone Number
310-900-8900
Fax Number
person
Provider Business Mailing Address Details
Address
3630 East Imperial Highway
City
Lynwood
State
California
Zip
90262-2678
Phone Number
310-900-8900
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
PA12007 (California)
Definition
Definition to come...
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