Healthcare Provider Details

I. General information

NPI: 1588090948
Provider Name (Legal Business Name): APRILYN NADINE CARL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS APRILYN NADINE WITT

II. Dates (important events)

Enumeration Date: 09/17/2013
Last Update Date: 09/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

758 HIGHLAND VIEW DR
CORONA CA
92882-8679
US

IV. Provider business mailing address

758 HIGHLAND VIEW DR
CORONA CA
92882-8679
US

V. Phone/Fax

Practice location:
  • Phone: 714-742-4884
  • Fax:
Mailing address:
  • Phone: 714-742-4884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA23222
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: