Provider Demographics
NPI:1336447689
Name:VARELA, XAVIER FERNANDO (PA-C)
Entity type:Individual
Prefix:MR
First Name:XAVIER
Middle Name:FERNANDO
Last Name:VARELA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4234 RIVERWALK PKWY STE 230
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3312
Mailing Address - Country:US
Mailing Address - Phone:951-781-3672
Mailing Address - Fax:951-781-0365
Practice Address - Street 1:4234 RIVERWALK PKWY STE 230
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3312
Practice Address - Country:US
Practice Address - Phone:951-781-3672
Practice Address - Fax:951-781-0365
Is Sole Proprietor?:No
Enumeration Date:2011-03-10
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105786363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical