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KAREN DECLUE PA-C

Medical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1174858534

Individual Registrant:
 KAREN  DECLUE PA-C
Gender: F
Not Sole Proprietor

Location and contact information for practice:
5059 YORK BLVD  HIGHLAND PARK, CA 90042-1713 US
Tel: 323-344-4144  Fax: 323-344-4146

Contact information for business:
801 S CHEVY CHASE DR #20 GLENDALE, CA 91205-4431 US
Tel: 818-755-8000  Fax: 818-755-8006

Registration Information:
NPI: 1174858534
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363AM0700XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
Medical
CAPA20524

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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