Provider Demographics
NPI:1699794081
Name:HALL, ANNE KELLY (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:KELLY
Last Name:HALL
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Gender:F
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:3791 KATELLA AVE
Mailing Address - Street 2:VASCULAR & GENERAL SURGERY ASSOC #201
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3105
Mailing Address - Country:US
Mailing Address - Phone:562-596-6736
Mailing Address - Fax:562-596-5387
Practice Address - Street 1:3791 KATELLA AVE
Practice Address - Street 2:VASCULAR & GENERAL SURGERY ASSOC #201
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3105
Practice Address - Country:US
Practice Address - Phone:562-596-6736
Practice Address - Fax:562-596-5387
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-11-29
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Provider Licenses
StateLicense IDTaxonomies
CA18483363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant