Individual provider · Type 1 NPI

Lacee Marie Childers, PA

Medical Physician Assistant · Riverside, CA

NPI number 1073816583 Active

Practice location

4445 Magnolia Ave
Riverside, CA 92501-4135

Call (951) 788-3200 Map

Fax (951) 788-3200

Mailing address

PO Box 79495
Corona, CA 92877-0183

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA21251 (CA)

Medical Physician Assistant: Definition to come...

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About NPI 1073816583

Lacee Marie Childers, PA's National Provider Identifier is 1073816583, issued on Dec 6, 2010. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Riverside, CA. The record was last updated on Sep 14, 2013.