Provider Demographics
NPI:1235697376
Name:FRANGOS, ELIAS CHRISTOPHER (PA-C)
Entity Type:Individual
Prefix:
First Name:ELIAS
Middle Name:CHRISTOPHER
Last Name:FRANGOS
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 1:12696 KIOWA RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92308-6962
Mailing Address - Country:US
Mailing Address - Phone:650-245-2257
Mailing Address - Fax:
Practice Address - Street 1:15962 QUANTICO RD
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-1302
Practice Address - Country:US
Practice Address - Phone:760-242-7560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56639363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical