Charese M Fannin, PA
NPI #1770517799 in Lynwood, California
Provider Information
- NPI Number
- 1770517799
- Entity Type
- Individual
- Name
- Charese M Fannin, PA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant - Medical
- Credential
- PA
- Enumeration Date
- Jul 10, 2006
- Last Updated
- May 6, 2015
Practice Location
- Address
- 3630 EAST IMPERIAL HIGHWAY
- City
- Lynwood
- State
- California
- ZIP Code
- 90262-2678
- Phone
- (310) 900-8900
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Medical — Medical |
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