Molly Anne Churlonis

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA54884 Issued in CA

Practice address

29100 Portola Pkwy Ste G
Lake Forest, CA 92630-8712

Phone

(844) 254-6382

NPI assigned

May 3, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1699201277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 W CANADA APT B",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724664",
            "telephone_number": "949-306-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29100 PORTOLA PKWY STE G",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926308712",
            "telephone_number": "844-254-6382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURLONIS",
        "first_name": "MOLLY",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-03",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA54884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rex G Chuang, D.D.S.
• Yentzu Chuang, ACUPUNCTURIST
• Jacob Thomas Chung, PT, DPT
• Demario Church
• Jordon Church
• Brittney Dawn Cicon, D.C.
• Circle of Health Physical Therapy, Inc.
• Monica Cisneros
• Stacy Clark, LMFT
• Julie Ann Claveria, M.D.

• Medical Physician Assistant in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.