Individual provider · Type 1 NPI

Kelsey Marie Glidewell, PA-C

Surgical Physician Assistant · Colton, CA

NPI number 1366951253 Active

Practice location

400 N Pepper Ave
Colton, CA 92324-1801

Call (909) 580-6170 Map

Mailing address

Phr Group Provider Enrollment Unit, 393 E Walnut St Fl 3
Pasadena, CA 91188-0001

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X54919 (CA)

Surgical Physician Assistant: Definition to come...

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About NPI 1366951253

Kelsey Marie Glidewell, PA-C's National Provider Identifier is 1366951253, issued on Sep 24, 2017. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Colton, CA. The record was last updated on Dec 8, 2021.