Provider Demographics
NPI:1730770942
Name:FELIX, FRANCISCO JAVIER (PA-C)
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:JAVIER
Last Name:FELIX
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36101 BOB HOPE DR STE A
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-2001
Mailing Address - Country:US
Mailing Address - Phone:800-285-3755
Mailing Address - Fax:
Practice Address - Street 1:1850 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-4621
Practice Address - Country:US
Practice Address - Phone:909-887-2991
Practice Address - Fax:909-887-5694
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-30
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1182003363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1182003OtherNCCPA