Shelley Dolkas Lickl PA

NPI 1760416572 - Physician Assistant - 363A00000X

NPI Details
NPI 1760416572
Gender Female
Enumeration Date 07/10/2006
Last Updated 06/18/2010
Entity Type Individual
Active Over 10 years ago
Practice Location
1 HOAG DR
ECU
NEWPORT BEACH CA, 92663-4162, US
Phone (949) 764-5689
Fax
Business Location
PO BOX 5445
ORANGE CA, 92863-5445, US
Phone (714) 637-4307
Fax (714) 282-9115
Toxanomy
Taxonomy Code 363A00000X
License State California
License Number PA17133
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According to our database, Shelley Dolkas Lickl PA NPI is 1760416572, taxonomy code is 363A00000X and license number is PA17133, license state is located at California. Shelley Dolkas Lickl PA physically located at 1 Hoag Dr, Newport Beach CA, 92663-4162. NPI Number Shelley Dolkas Lickl PA has the Individual type.

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1760416572 NPI number is provided on an as is basis without warranty of any kind. 1760416572 is maintained by the National Plan & Provider Enumeration System. The contents of Shelley Dolkas Lickl PA are for informational purposes only.