Provider Demographics
NPI:1285035808
Name:MEWES, CHRISTIAN (PA)
Entity Type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:
Last Name:MEWES
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 SONIA PL
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-3306
Mailing Address - Country:US
Mailing Address - Phone:224-619-5023
Mailing Address - Fax:
Practice Address - Street 1:913 SONIA PL
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-3306
Practice Address - Country:US
Practice Address - Phone:760-725-4866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085008517363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant